February 2023 Report Highlights Dangerous Consequences of Corporate Healthcare Mergers in the United States
Ethical Minnesota medical professionals and medical students provide evidence of why bigger is not better in healthcare
The Minnesota Nurses Association (MNA) earlier this month released a new report on the proposed merger of Sanford Health and M Health Fairview into a massive new healthcare chain. The 24-page report includes a review of scholarly studies on the effects of healthcare mergers on patients, workers and communities, as well as a review of the corporate policies pushed by hospital executives at Sanford and Fairview, including closures of facilities and units with their focus on the bottom line.
As of this writing, Fairview and Sanford have now announced that they are voluntarily extending the competition of the merger to May 31, 2023.
You can read the full report here.
(“Tears on the Table.” The editor receiving intensive specialized physical therapy treatment over the course of a full year in 2021 for an injury sustained in 1996. Photo by Kamila Rylander.)
“A merger between these two systems would create one of the largest healthcare providers in the Upper Midwest and could dramatically change the lives of patients, healthcare workers, and their communities,” the report states. “Mergers make our hospitals less accountable and less connected to communities, resulting in higher costs for patients, reductions in services, and increased burnout for healthcare workers. We urge the Attorney General and elected officials to continue to act in the interest of patients, workers, and their communities and prevent the further entrenchment of corporate healthcare in Minnesota.”
For healthcare workers, the report highlights research that shows that these corporate mergers result in decreased job satisfaction and increased burnout for workers, especially emotional exhaustion. In Minnesota, this would come at a time when over 50 percent of all nurses are considering leaving the bedside due to the corporate healthcare policies pushed by hospital executives that have forced nurses to work through under-staffing and moral injury. These workforce issues affect not only nurses, but physicians and other healthcare workers at a time when Greater Minnesota is especially in need of healthcare providers.
For patients, the report summarizes scholarly research that has found that mergers like the one proposed between Sanford Health and M Health Fairview result in higher costs for patients, no increase in service, and often “worsening patient experiences.” These effects happen when hospital chains monopolize local healthcare services, close clinics or units, and push hospital staffing levels lower.
The report dives deeply into the concerning history of corporate healthcare policies pushed by executives at Sanford Health and M Health Fairview. At Sanford, while pursuing frequent mergers to grow the geographic footprint of their hospital chain, executives have slashed local services. The new study summarizes reports from Minnesota nurses on the services that have been eliminated since Sanford Health took over their community facilities. These include:
Elimination of mental health services
Elimination of home health services
Elimination of Cardiac Critical Care Unit
Elimination of cardiac rehabilitation services
Elimination of in-home physical and occupational therapy
Elimination of Intensive Care Unit (ICU)
Elimination of wound care services
Elimination of ostomy services
Elimination of Respiratory Therapy services
Elimination of outpatient services (including MRIs, mammograms, surgeries, and ultrasound)
Drastic reduction in surgery cases
M Health Fairview executives, meanwhile, have their own record of corporate consolidation and closures. In 2017, Fairview acquired HealthEast, a system whose hospitals have long served low-income communities and communities of color in the East Metro. Fairview executives subsequently closed two HealthEast hospitals, Bethesda and St. Joseph’s, including the state’s only dedicated COVID-19 hospital in the middle of the pandemic. Now, Fairview executives are replacing these closed community hospitals with a for-profit company to build and operate a new facility in the East Metro.
While Sanford and Fairview executives have taken a barebones approach to staffing and services, there’s nothing minimal about the executive compensation at these two hospital systems. Since arriving at Fairview in 2017, CEO James Hereford has received more than a 100 percent increase in his total compensation. With annual compensation of $2.8 million, he makes more than 32 times the salary of the average nurse in the Twin Cities. Over in Sioux Falls, Sanford recently paid out a $49.5 million golden parachute to their disgraced former CEO after he spread medical disinformation to employees of the massive health system.
MNA nurses are supporting legislation to provide critical public oversight of proposed hospital mergers like the one being pursued by executives at Sanford Health and M Health Fairview. The proposed legislation (HF 402, Rep. Robert Bierman) would give state officials the authority to review – and approve or deny – hospital mergers in the state based on their impacts on Minnesota patients and communities.
*Copublished with the permission of the Minnesota Nurses Association.
Again, read the full report here.
Additional Resources
Join the Quarterly Update from Minnesota Healthcare For All on March 9, 2023 at 6:30pm via ZOOM at Healthcare For All Minnesota