Grassley asked the health system to answer various questions by June 14 about how it will uphold high standards of patient care and protect workers who raise complaints, and how billing uninsured or underinsured patients will be handled under a for-profit firm.
“I am concerned about private equity’s impact on patient care and outcomes at your hospital,” wrote Grassley, who is one of the two ranking members of the Senate Budget Committee who opened an investigation in December on the impact of private equity on the nation’s hospitals.
SCP Health is majority-owned by Onex Partners, a for-profit private-equity firm. Meanwhile, St. Louis-based Ascension is a nonprofit Catholic health system with 10 hospitals in the Chicago area.
In his letter, Grassley points to Ascension’s mission of serving vulnerable and poor patients, contrasting it with Onex’s mission to deliver financial returns for its investors and partners.
“These objectives are competing and stand in stark contrast in principle and spirit with Ascension’s stated mission and services,” Grassley wrote.
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Ascension’s outsourcing move, which Crain’s first reported in March, has faced backlash from many of the affected workers. As Crain’s reported yesterday, about 35% of the 110 full- and part-time hospitalists, which include medical directors, doctors, physicians assistants, nurse practitioners and other providers, plan to leave Ascension when the outsourcing transition takes place tomorrow. Hospitalists are clinicians who take care of patients during a hospital stay.
Hospitalists against the outsourcing move previously told Crain’s they were worried about SCP Health’s private-equity ownership, a fact they have said will lead to larger patient caseloads at some Ascension hospitals, proposed under the staffing firm’s contracts, as it seeks to grow revenues.
In his letter, Grassley specifically called out SCP Health’s staffing models, citing a copy of a contract his office received from a whistleblower. It shows the average number of patients hospitalists would see per day would grow from between 16 and 19 now to between 22 and 30. The national average patient load for hospitalists is currently between 14 and 15, according to the Society of Hospital Medicine.
“I am concerned that if the staffing plans are executed as stated to my office, hospitalists would carry very high patient loads,” Grassley wrote.
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“If hospitalists are to carry such high patient loads, it raises legitimate questions about how medical care can be efficiently approved and performed in a manner adequate for each patient’s specific requirements,” he continued.
In a statement to Crain’s, Ascension said it received Grassley’s letter and looks “forward to sharing information on how our arrangement with SCP Health will serve our patients, our community and our mission.”
SCP Health did not respond to a request for comment.
The letter from Grassley’s office is just the latest piece of criticism being lobbed at Ascension’s deal with SCP Health. The Chicago Medical Society, which represents more than 17,000 local physicians, including some at Ascension Illinois, expressed worries over how the deal would impact patient care shortly after it became public.
Meanwhile, the Illinois Nurses Association was more direct, calling the move “a private-equity scheme” that has the potential to harm patient care if caseloads are increased.
The situation at Ascension Illinois represents another flashpoint in the ongoing debate about whether private equity hurts the American healthcare system. Private equity firms have deepened investments into the healthcare sector in recent years, particularly in staffing firms, which many U.S. hospitals have come to rely on.
In March, the U.S. Department of Justice and other federal agencies launched a probe to examine if private-equity interests are damaging healthcare workers, quality of care and affordability.
This story first appeared in Crain's Chicago Business.
