WHEN THE national health care company Optum acquired Massachusetts-based Atrius Health last year, the deal set the stage for the emergence of the state’s third conversion foundation.
A conversion foundation is the byproduct when a for-profit health care company (Optum) buys a nonprofit (Atrius). A chunk of the sale price, in this case $236 million, goes toward a foundation that fulfills some of the original nonprofit’s goals.
The new foundation – the Atrius Health Equity Foundation – is expected to be up and running soon and its emergence is casting a spotlight on the state’s first two conversion foundations, which were formed in the late 1990s.
Amie Shei, president and CEO of the Health Foundation of Central Massachusetts, and Martin Cohen, president and CEO of MetroWest Health Foundation, talked about some of the achievements of their organizations on The Codcast with John McDonough of the T.H. Chan School of Public Health and Paul Hattis of the Lown Institute. (They also co-authored a commentary piece in CommonWealth.)
Shei said the Health Foundation, which is focused on the Worcester area, has handed out $52 million in grants to 220 unique organizations.
One of its earlier initiatives addressed an unusually high rate of pre-school expulsions in Worcester by launching behavioral health interventions to help children adapt. Shei said success in Worcester paved the way for an initiative covering all of Massachusetts funded by the state.
Shei said the foundation is also lobbying for legislation to extend state regulations covering public water supplies to private wells that provide the bulk of drinking water in more rural areas of Massachusetts.
Cohen said an early focus of his foundation was the opening of a community health center in Framingham which is called the Edward M. Kennedy Health Center. A second has been added in Milford, he said.
He said the foundation was the lead funder in 2003 of a program of the Framingham Police Department to send behavioral health experts on police calls to help divert people for treatment who previously might have ended up in jail. He said that program has now been replicated in 37 communities across the state.
Cohen also takes pride in an adolescent health survey of 42,000 public school students that provides useful information for policymakers. He noted the survey provided evidence that Needham’s decision to raise the age requirement for purchasing tobacco products to 21 was reducing smoking. That evidence helped pave the way for other communities in Massachusetts and New York City to raise their age requirement for tobacco products.
Both Shei and Cohen said they think Massachusetts should join California, New Mexico, and other states that are providing health insurance for undocumented immigrants. Legislation to provide the insurance has been filed on Beacon Hill.
“I would certainly see it as a benefit to residents in our area,” Cohen said.
McDonough asked if the two nonprofit leaders have a preference for non-profit or for-profit health care providers.
Shei didn’t answer directly, instead focusing on why some nonprofit providers are being absorbed by for-profit competitors. “I see the conversion as an inevitable result of consolidation and other changes in the health care marketplace that rendered it difficult for smaller nonprofit health care entities to remain independent and viable,” she said.
Cohen said the difference doesn’t matter much when it comes to care but may affect what role the provider plays in the local community.
“I don’t think the question is really one of tax status,” he said. “I don’t think anyone in the middle of the night thinks about am I going to go to a for-profit or a not-for-profit hospital. The question is commitment to things other than the bottom line.”
He said the closing of nonprofit health care providers has had an impact in local communities. “I think there is something that has been lost, and that’s the concept of the hospital as being part of a larger community,” he said.
