As part of a regulatory process for a health care merger, Rhode Island Attorney General Peter Neronha announced Tuesday he is requiring the state’s largest hospital system, Brown University Health, to play a bigger role in reducing a shortage of primary care doctors in the state.
Neronha said Brown University Health will hire 27 new primary care doctors and take on 40,000 new primary care patients over the next four years, in exchange for his approval of a proposed merger with Brown Physicians Inc., a medical practice that already provides many of the health system’s doctors.
“This was an opportunity to use our antitrust authority to ensure that at least one major institution, over whom I had jurisdiction in the moment, committed itself, regardless of what the cost is, to bring on the number of patients that will be a major step forward,” Neronha said.
“I’m confident that they’ll be able to do it,” Neronha continued, “and if they don’t, well then, you know, there are consequences for that.”
After securing these and other commitments, Neronha suspended an antitrust investigation required under state law. Neronha could sue to reopen it if Brown University Health does not fulfill the commitments. Neronha said the hospital network will report on its progress to the attorney general’s office twice a year.
Brown University Health also committed to providing new patients a primary care appointment within 14 days. Neronha framed this as a radical change from the current situation in Rhode Island, which he described as a “primary care crisis.”
“Your odds are probably better winning the Powerball than finding a new patient appointment anywhere in this state within 14 days,” Neronha said.
Brown University Health officials said it will cost the hospital system an additional $4 million per year to fulfill this staffing level for primary care doctors. But President and CEO John Fernandez framed this as a financial benefit in the long run, because it will bring in new patients to use the hospital’s more profitable services.
Still, he said the merger will not come close to solving Rhode Island’s shortage of primary care doctors. And officials said it’s possible expanding Brown University Health’s primary care department could wind up pulling doctors away from other Rhode Island practices.
“We have hospitals going bankrupt, physician groups going bankrupt,” Fernandez said. “This is just an important step for us in our success, but we’ve got a bigger crisis we should be more worried about.”
Nearly every official at Tuesday’s press conference stressed that Medicaid, Medicare, and private insurance companies continue to reimburse hospitals at lower rates in Rhode Island than in Massachusetts or Connecticut. That means doctors can earn more in nearby states, and some hospitals in Rhode Island struggle to break even financially.
“I’m worried about the amount of revenue coming into our health care system,” Neronha said. “Until we fix that dynamic, these problems are going to come back.”
The proposed merger between Brown University Health and Brown Physicians Inc. now goes before the Federal Trade Commission for approval. Neronha said the commission’s staff has already provided a recommendation to the commission’s voting body.
“I expect this transaction to move forward, let’s put it that way,” Neronha said.
