What's up with Steward Health Care?

Also: Inside the ketamine economy [Donate ❤️]( [View in Browser](  January 30, 2024 Hi CommonHealth reader, This is one of the strangest times I can remember in Massachusetts health care. Last week, hundreds of people gathered at the Westin Copley Place hotel for the local hospital association's annual meeting. They talked about everything from workforce shortages to the presidential election to climate change. But one topic that was not on the agenda kept coming up: Steward Health Care. Steward is one of the largest hospital operators in Massachusetts, and it’s unusual. It’s a privately held for-profit company that was founded with private equity backing in 2010. It has nine hospitals in this state, among dozens nationwide, and it appears to be in serious financial peril. In fact, Steward may be at the brink of failure. [Health care leaders and public officials are racing to develop a plan]( to shore up the state’s health care system in the event that Steward runs out of money to continue operating, or its hospitals suddenly close. They haven’t announced a plan yet, though Gov. Maura Healey said Steward [would not receive a state bailout.]( (The governor said her goal is “to make sure that patients are protected, that jobs are protected and that the health care system in Massachusetts is stabilized.”) Hospitals across the state are already crowded and often struggling to meet the needs of all the patients who require urgent care. Health care leaders are anxious about what could happen if any hospitals close. "We’re really looking at this as a disaster," Katie Murphy, president of the Massachusetts Nurses Association, told me. "When I think about the gridlock we have, if we lost any more beds, it would really be a crisis." Patients are already feeling some impacts. Mass General Brigham said Friday it would stop sending its doctors to do surgeries at Steward’s Holy Family Hospital in Haverhill and Methuen, because certain equipment “might not be available.” A heartbreaking [Boston Globe story]( detailed how one medical device was needed to save the life of a new mom who suffered unexpected complications at Steward-owned St. Elizabeth’s Medical Center in Brighton. But Steward hadn't paid its bills, and the hospital's medical devices had been repossessed. Steward has made some puzzling business decisions over the years — including [selling its real estate]( to a trust and agreeing to make hefty [rent payments]( on its hospitals. The company, though, [blames low reimbursements]( from insurers for its financial troubles. Sen. Elizabeth Warren [isn't buying that](. “Steward’s explanations for its failings do not add up,” Warren said in a statement Monday. “It’s clear that Steward executives put profits over patients and went to great lengths to hide critical information about its financial status from state officials, jeopardizing quality health care for the people of Massachusetts.” What’s next? We're waiting to see Steward's next move — and how the health care community and public officials respond. Meanwhile, the clock is ticking on Steward’s debt obligations. Expect more news soon. P.S.— A few weeks ago in this space, I told you about a new insurance policy at Blue Cross Blue Shield of Massachusetts that would have [limited the use of anesthesia]( for many people getting colonoscopies. This idea elicited strong reactions, and Blue Cross officials apparently heard them. The company has decided to [pause implementation]( of the policy. A big thank-you to all the readers who emailed about this. 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