Beaumont, Summa Health cancel $6.1B merger plan

Summa Health's deal with Beaumont: 5 things you need to know ...Beaumont Health to acquire Ohio's Summa Health system

Southfield, Mich.-based Beaumont Health announced May 29 that it is calling off a proposed merger with Akron, Ohio-based Summa Health. 

The health systems are ending talks about five months after signing a definitive agreement, under which Summa Health would have become a subsidiary of Beaumont. The health systems announced in April that they were delaying the deal due to the COVID-19 pandemic.

“The organizations are now finalizing details and next steps to end the planned partnership,” reads a joint statement from Beaumont and Summa. “Throughout this process, each of the organizations has continued to operate independently, and each will continue to focus on providing exceptional health care services for their respective markets.”

The proposed deal, which had already received all necessary regulatory approvals, would have created a nonprofit system with 12 hospitals and $6.1 billion in annual revenue. 

Beaumont and Summa’s announcement comes just three days after four Chicago hospitals called off their plans to merge. Several other deals have been canceled or delayed since Jan. 1. 





Insurers continue to pay rebates while providers struggle

Reform Brings More Health Insurance Rebates |

Blue Cross Blue Shield of Michigan became the latest health insurer to announce plans to refund money to its enrollees, as reimbursement for healthcare services dropped in the wake of the coronavirus pandemic, with many hospitals and physicians curtailing operations. The company will return $100M to enrollees, in the form of premium discounts and refunds, and said it might increase that amount later in the year depending on how quickly health spending picks up again.

UnitedHealthcare (UHC), Cigna, and Humana are among the other insurers who have recently announced similar plans, with UHC alone slated to give back $1.5B to purchasers. Under the Affordable Care Act, plans must spend between 80 and 85 percent of the premiums they collect on medical care, depending on the segment of the market they cover, and must return excess profits to purchasers if they do not. Insurers are getting ahead of this requirement by returning money now to their employer and individual-market customers.

Meanwhile, some industry observers have begun to question why insurers, who have weathered the pandemic in good financial shape, are not spending more to stabilize the operations of struggling hospitals and physicians in their networks. For instance, Harvard researchers Leemore Dafny and Michael McWilliams proposed this week that insurers extend a “primary care boost” of 50 percent to their payments to doctors through the end of this year. Getting plans to act in concert to support providers will prove to be challenging, of course, and the temptation to free-ride on others’ generosity and instead “spend” excess premium dollars to return cash to customers may prove too strong for its public relations and loyalty benefits.

Or perhaps there are more Machiavellian motives at play: allowing physician practices to suffer financially could result in lower practice valuations, as insurers set their sights on further “vertical integration” plays in the months to come.




10 hospital deals called off, delayed

Beaumont, Summa Health Delay Hospital Merger Until After COVID-19

Below are 10 hospital transactions or partnerships that have been delayed or called off since Jan. 1, beginning with the most recent:

1. Pandemic delays UMass Memorial’s acquisition of Harrington HealthCare
The COVID-19 pandemic has pushed back UMass Memorial Health Care’s acquisition of Harrington HealthCare, a Southbridge, Mass.-based system comprising a 119-bed hospital,  satellite location and three medical office buildings.

2. Jefferson Health, Temple call off cancer center deal
Thomas Jefferson University will no longer purchase the Fox Chase Cancer Center from Temple University due to the “devastating economic impact of COVID-19.”

3. St. Luke’s takeover of Kansas hospital pushed back amid COVID-19 crisis
The date that St. Luke’s Health System will take over Allen County Regional Hospital in Iola, Kan., has been pushed back due to the COVID-19 pandemic.

4. Astria Health cancels sale of hospitals as COVID-19 affects markets 
Yakima, Wash.-based Astria Health, which filed for Chapter 11 bankruptcy in 2019, has taken its hospitals off the market.

5. Beaumont, Summa Health delay merger
Southfield, Mich.-based Beaumont Health is delaying its merger with Akron, Ohio-based Summa Health due to the COVID-19 pandemic, Beaumont CEO John Fox said during a news briefing April 21.

6. North Carolina health systems call off partnership talks
Citing uncertainties brought on by the COVID-19 pandemic, Greensboro, N.C.-based Cone Health has ended talks to become a successor to Asheboro, N.C.-based Randolph Health after Randolph emerges from bankruptcy.

7. New York hospital to split with Ascension after 18 years
St. Mary’s Healthcare in Amsterdam, N.Y., became an independent hospital after 18 years as a member of St. Louis-based Ascension.

8. Geisinger, AtlantiCare sever merger
Danville, Pa.-based Geisinger and Atlantic City, N.J.-based AtlantiCare have agreed to part ways, the two health systems announced March 31.

9. Home healthcare providers abandon $1.25B deal amid FTC probe 
Two home healthcare providers, Aveanna Healthcare and Maxim Healthcare Services, have terminated their proposed acquisition agreement, the Federal Trade Commission said.

10. FTC sues to block Jefferson Health-Einstein Healthcare merger
The Federal Trade Commission will sue to block the merger of Philadelphia-based Jefferson Health and Einstein Healthcare Network, a deal that has been pending since 2018. The commission said it will seek a temporary restraining order and a preliminary injunction to prevent the deal.




COVID-19 pushes Mayo Clinic’s operating income into free fall

Farrugia calls 2019 'a year of remarkable growth' as Mayo reports ...

Dive Brief:

  • Prior to the onset of the novel coronavirus, Mayo Clinic was cruising along with a healthy operating margin of 6.7% during the first two months of the quarter. But by the close of the period, the operating margin was squeezed to just 0.9% while net operating income fell off a cliff, free falling 88% to $29 million compared to the first quarter of 2019.
  • Due to contracting services and the near closure of its outpatient business in response to the pandemic, revenues for the quarter declined nearly 4% while expenses rose 3% compared to the prior-year period.
  • The fluctuation in the financial markets caused a downturn in Mayo’s investment portfolio, leading to an overall net loss of $623 million for the Rochester, Minnesota-based nonprofit health system.

Dive Insight:

Mayo Clinic is the latest hospital operator to report it first quarter results have been battered by the pandemic.

The system, which took in more than $1 billion in operating income in 2019, joins other major hospital operators that reported a dip in volumes amid the public health crisis, including HCA and CommonSpirit.

The second quarter is not likely to look better, according to Fitch Ratings. The second quarter looks bleak as the ratings agency issued an ominous report predicting it would be the “worst on record” for most nonprofit hospitals.

Yet, some of the for-profit hospital operators see May as the beginning of the recovery. Both Tenet and CHS executives seemed upbeat about the prospects for this month, noting it was the start of resuming elective procedures that had been put off.

Despite the hospital sector as a whole taking a major hit from the pandemic, big wealthy systems like Mayo have significant rainy day funds. Mayo reported cash and investments of more than $10.6 billion as of March 30 with 252 days cash on hand.

In April, Mayo issued a voluntary notice about how the virus was taking on its business, noting reduced salaries for executives and physicians, furloughs and a hiring freeze, among other efforts.​

In its first quarter report, Mayo detailed the ways in which it’s tackling the novel coronavirus on the medical front, including leading a program, approved by the FDA, that gives severely sick COVID-19 patients plasma from those who were previously sickened but have since recovered from the virus.

Mayo said it’s preparing the program’s first safety report on the first 5,000 patients to receive the infusion. As of May 12, more than 9,300 patients have been infused, Mayo said.

The system also runs COVID-19 testing, and said it is now able to administer 8,500 molecular tests and 20,000 serologic tests, which look for antibodies to the virus in those that may have been previously infected, daily.



CommonSpirit posts $1.4B loss, says full COVID-19 impact unknown

Locations | CommonSpirit Health

Dive Brief:

  • CommonSpirit Health, sprung from last year’s merger of California-based Dignity Health and Colorado-based Catholic Health Initiatives, reported a loss topping $1.4 billion in the fiscal third quarter ending March 31, although adjusted revenues were flat compared to the third quarter of 2019. The biggest proportion of losses were tied to investments, as its portfolio dropped in value by nearly $1.1 billion. Its total net assets are down nearly $2.5 billion from a year ago.
  • Like many other hospital systems, CommonSpirit reported a drop in patient volumes that began in mid-March as states began issuing lockdown orders. Acute admissions dropped more than 5% for the quarter compared to a year ago.
  • CommonSpirit did receive more than $700 million in Coronavirus Aid, Relief, and Economic Security Act funds, although since it was received on March 31 it will be booked into its fiscal fourth quarter financial statements. The system received another $2.6 billion in accelerated payments from CMS and anticipates receiving another $410 million in disaster relief funding and from the Paycheck Protection Program.​

Dive Insight:

The COVID-19 pandemic is continuing to ravage the bottom lines of providers, and the nation’s largest not-for-profit hospital system, CommonSpirit Health, is no exception.

Its first full year as a unified system is 2020, and the COVID-19 pandemic is challenging the 134-hospital organization in ways it likely never anticipated. Admissions are down for the foreseeable future, coupled with the need to spend tens of millions of dollars on personal protective equipment, respirators and to divert a significant amount of resources toward treating coronavirus patients.

Fitch Ratings said COVID-19 is to blame for the worst second quarter for most U.S. hospitals and systems.

For the third quarter of 2020, CommonSpirit reported an operating loss of $145 million, compared to a pro forma $124 million loss reported by Dignity and CHI for the first quarter of 2019.

CommonSpirit posted a net loss of $1.4 billion for the third quarter, compared to a pro forma net gain of $9.7 billion for the third quarter of 2019. However, $9.2 billion of that came from what CommonSpirit termed a “contribution from business combination,” the net assets received from both parties by merging with one another. For the first nine months of fiscal 2020, CommonSpirit lost $1.1 billion on revenue of $22.4 billion, compared to a net gain of $9.5 billion on revenue of $21.6 billion over the same period in fiscal 2019.

And despite receiving some $3.7 billion in federal assistance, CommonSpirit said in its quarterly financial disclosures that it remains too soon to tell what the impact of COVID-19 will be on the organization over the long-term.

Prior to the pandemic, CommonSpirit’s financial position was trending stronger compared to its pre-merger state. Seven of its 14 operating divisions reported a jump in revenue during the quarter compared to 2019.





For-profit, higher-margin hospitals at advantage when it comes to CARES funding

Understanding the CARES Act student loan relief | Sanford Center ...

Dive Brief:

  • Hospitals that tend to have a higher mix of private payer revenue are likely to receive more novel coronavirus federal grant money compared to hospitals that rely on government payers such as Medicare and Medicaid, a new analysis from the Kaiser Family Foundation found.
  • The study aims to analyze the implications of tying the latest round of $50 billion in federal bailout money to providers’ net patient service revenue. It examined hospital financial data and used the HHS’ grant formula to determine the amount of grant money hospitals were likely to receive.
  • KFF found that hospitals with the highest share of private insurance revenue, or those in the top 10%, received $44,321 per hospital bed, or more than double the hospitals in the bottom 10%.

Dive Insight:

This latest analysis reveals some hospitals may be at a disadvantage when it comes to receiving federal funding that is meant to serve as a lifeline for them during the COVID-19 pandemic.

The study found that hospitals with the highest share of private insurance revenue — and those set to receive more in bailout money — were less likely to be teaching hospitals and more likely to be for-profit. Also, they were more likely to have higher operating margins and provided less uncompensated care as a share of operating expenses.

In short, KFF explains that the funding package is skewed toward hospitals with higher revenue from private payers.

“These hospitals’ large share of private reimbursement may be due either to having more patients with private insurance or charging relatively high rates to private insurers or a combination of those two factors. All things being equal, hospitals with more market power can command higher reimbursement rates from private insurers and therefore received a larger share of the grant funds under the formula HHS used,” according to the analysis.

The study points out that a community health center that sees a small portion of patients with private pay would receive less funding than a private physician office that sees the same total number of patients but treats more with private pay.

“With HHS expected to release additional relief fund grants and Congress considering additional stimulus, this analysis demonstrates that the formula used to distribute funding has significant consequences for how funding is allocated among providers,” according to KFF.

Hospitals have been battered by the outbreak of the novel coronavirus. They’ve halted elective procedures and routine care in an effort to preserve needed medical supplies and in an attempt to snuff out the spreading virus.

That has caused hospital volumes and revenues to plummet as care is deferred, so the federal government has sent financial aid in response as part of the Coronavirus Aid, Relief, and Economic Security Act.

This latest round of funding was designed to be a more targeted approach than the initial wave. The first $30 billion released was distributed based on a facility’s share of Medicare fee-for-service. That put facilities with a small slice of Medicare fee-for service business, such as children’s hospitals, at a disadvantage. However, the first round was one way to get money out the door quickly, which officials have acknowledged, knowing a more targeted approach would follow.





Prospect Medical Group to add 10,000 physicians with 3 acquisitions

Prospect Medical Group to acquire three physician practices

Prospect Medical Group will double in size when it completes the acquisition of three medical practices later this year. 

Prospect Medical Group, owned by Los Angeles-based Prospect Medical Holdings, entered into an agreement April 22 to acquire certain assets of CalCare IPA and Los Angeles Medical Center IPA, both of which serve Los Angeles County, and Vantage Medical Group in San Diego, San Bernardino and Riverside, Calif.

The transaction, which is subject to customary closing conditions and approvals from contracted health plans, is expected to close this summer. 

The three independent medical associations, representing more than 10,000 physicians, will join Prospect’s existing network of about 10,000 providers when the transaction closes.

“This is a great opportunity to expand Prospect’s system of coordinated care to a much larger market,” said Prospect Medical Systems CEO Jim Brown. “Our vision is that everyone has access to quality health care when they need it, and we look forward to partnering with a new network of physicians to make that a reality.”