Columbia/HCA Healthcare Corp. put down roots in the academic medical mecca of metropolitan Boston last week, completing a joint venture giving it an 80% stake in MetroWest Medical Center.
The deal gives the company its first hospital in Massachusetts. And it marks the end of an 11-month regulatory gantlet that accompanied the first acquisition of a majority interest in an acute-care hospital by a for-profit business in that state.
The final hurdle was cleared in mid-April when state Supreme Court Justice Charles Fried approved revised terms of the partnership reached in negotiations with Attorney General Scott Harshbarger (April 8, p. 28).
In announcing the deal's completion, Columbia immediately started dropping names of Harvard-affiliated programs associated with MetroWest through teaching affiliations or ties with physician staffs.
But those associations largely involve tertiary facilities that will be major competitors of Columbia now that the company is in their back yard at MetroWest campuses in west suburban Framingham and Natick.
And the one teaching hospital in Boston that had been discussing an arrangement with Columbia, New England Medical Center, formally committed last week to discussions with Partners HealthCare System, parent of Massachusetts General Hospital and Brigham and Women's Hospital.
Columbia said MetroWest has teaching affiliations with Beth Israel Hospital, Children's Hospital and Massachusetts General, all affiliates of Harvard Medical School.
But the Massachusetts General affiliation consists of a lone pediatric residency where residents rotate through MetroWest as a field location once a month, said spokeswoman Peggy Slasman. Several residents also spend one day a week helping staff a clinic.
In addition, the announcement mentioned a MetroWest teaching affiliation with Boston University Medical School. MetroWest also houses a suburban satellite facility of Boston's Dana-Farber Cancer Institute, which recently announced an affiliation with Partners (Jan. 22, p. 16).
Columbia's prospects of buying into the academic teaching market may have faded when the board of New England Medical Center last week authorized discussions with Partners. That authorization came one day after Columbia announced completion of its MetroWest partnership.
New England Medical had "spoken with Columbia" among others in discussions about potential partnerships since it broke off talks in July 1995 with Pathway Health Network, said spokeswoman Joan Fallon.
Pathway, which includes Harvard affiliate New England Deaconess Hospital and four other Boston-area facilities, has since agreed to merge with Beth Israel (April 29, p. 4). New England Medical, affiliated with Tufts University Medical School, is the only major Boston teaching hospital without a partner.
But according to a statement by Partners President Samuel Thier, New England Medical had initiated preliminary talks during the past several months, leading up to the formal board vote last week to continue those discussions.
To compete with Partners and other developing networks, Columbia has a growing New England network that also includes Portsmouth (N.H.) Regional Hospital and Pavilion; Parkland Medical Center in Derry, N.H.; and surgical centers in Fall River, Mass., and in Pawtucket and Providence, R.I.
With MetroWest it gains a financially sound medical center midway between Boston and Massachusetts' second-largest healthcare market of Worcester. In 1995, MetroWest's net income was $8.4 million on revenues of $149 million, for a profit margin of 5.6%, according to HCIA, a Baltimore-based healthcare information company.