Health Policy Commission outlines expedited reviews of Steward Healthcare sales and seeks commitments on access and accountability

The Health Policy Commission (HPC) on Tuesday detailed its expedited reviews of asset sales arising from Steward Healthcare’s bankruptcy and urged potential buyers to provide public commitments on preserving services and access.

Executive Director David Seltz opened the briefing by framing Steward’s bankruptcy and subsequent hospital closures as “one of the most challenging and distressing moments” for the state’s health system and said HPC staff would deploy data and statutory review tools to assess impacts. “We will make our data resources and our expertise available,” Seltz said, asking commissioners to flag priorities for the reviews.

Megan Wolf, leading the staff presentation, walked commissioners through recent filings and court approvals. She said the bankruptcy process produced several court-approved sales: Lifespan acquired St ANS and Morton hospitals for a reported $175 million; Lawrence General purchased the two Holy Family campuses for $28 million; Boston Medical Center acquired St. Elizabeth’s and Good Samaritan for $140 million; and a Brady Health buyer affiliated with Rural Healthcare Group (and tied to private-equity interests) agreed to buy Steward Health Inc. and the Steward Physician Network for about $245 million. Wolf said many purchases exclude Steward’s real-estate leases but often include arrangements to negotiate new leases with the landlord.

Wolf summarized the physician-network scale: Steward’s network registered roughly 2,950 physicians in early 2022 (about 400 primary care physicians and the remainder mostly specialists), although staffing and contracting patterns have changed since. She told commissioners the Brady Health buyer is proposing to acquire a reduced set of clinicians, and staff are working to understand how many physicians and support personnel would move under the new contracts.

Commissioners pressed staff and parties on accountability and enforceable protections. Commissioner Foley said access should be the review’s primary focus and urged staff to secure clear plans for preserving service lines in communities affected by closures. Commissioner Blakey urged a careful review of Kinderhook Industries’ and other buyers’ past acquisition histories. Staff replied that the HPC can request confidential documentation, require reporting commitments and, where appropriate, recommend a Cost and Market Impact Review (CMIR), which is a lengthier, deeper inquiry.

Staff emphasized the limits of HPC authority — it cannot unilaterally block a deal — but noted the review process can require public commitments, additional reporting and follow-up in hearings such as the annual Cost Trends process. Megan Wolf said federal reviews are ongoing in some cases and that the HPC is coordinating with other state and federal regulators, including the Department of Public Health.

The board closed the Steward discussion by asking staff to prioritize questions about continuity of care, physician privileges at acquiring hospitals, workforce transitions and equity measures in public commitments. Staff said they will brief commissioners on findings confidentially where appropriate and report public recommendations at upcoming board meetings.

Vote at the meeting: The board approved the minutes from its July 18 meeting. One commissioner (Commissioner McGregor) abstained because they were not present for the prior meeting.

What’s next: Staff said several hospital closings and sales are targeted for late-September closings, and the HPC will continue rapid MCN reviews and decide whether any transactions warrant a CMIR. Commissioners scheduled additional public review at the full board meeting on Oct. 10.

Sources: Public presentations and Q&A at the HPC meeting (staff presentation by Megan Wolf; remarks by Executive Director David Seltz).