Partners HealthCare goes global: Is it a good idea?

In shift, Partners HealthCare seeking growth globally in today's Boston Globe describes how Partners is turning its focus from dominating the Massachusetts healthcare delivery system to looking for revenue growth overseas.This wasn't hard to predict, and it makes a good deal of sense. Last year the Globe asked me to speculate on whether Partners' hiring of a new CEO would change the company's strategic course. I said it was surprising that Partners had continued its relentless expansion in Massachusetts. While it made sense to affiliate with community hospitals and physician practices to generate complex referrals for "tertiary" care, it was puzzling why Partners wanted to be in the business of offering the most cost-effective colonoscopies and other routine services throughout the state, generating friction with the state government, health plans, employers and consumers as a byproduct.I suggested that Partners might choose to return to its roots as a world-renowned academic medical center with its Massachusetts General and Brigham and Women's hospitals. Interestingly, from today's article it appears that MGH and the Brigham --not Partners itself-- are the entities that are driving forward. MGH plans to manage a hospital in China near Macau while the Brigham has recruited a chief business development officer from Johns Hopkins to set up business in the usual hotspots for high-dollar international medical ventures, i.e., China and the Persian Gulf, with a nod toward emerging South American economies.Using the MGH and Brigham brands is wise, and helps remind us of just what Partners is. Remember, Partners was established to prevent health plans and the state from playing MGH and the Brigham off of one another in contract negotiations. The two hospitals continue to exist --it is not a merger in the traditional sense.But these entities will have to be careful when they go abroad prospecting for gold. A few things to watch out for:

• Politics: Picking one foreign partner in a region can mean foregoing the opportunity to work with that entity's rivals. And if an emir is ousted his successor may shoot down the pet projects of the previous emir and his family. (It has happened!)
• Brand risk:  When I traveled to Asia a decade ago to research medical tourism, the Harvard name and crest were splashed up all over the place by operators who had little or nothing to do with Harvard. That had something to do with an earlier venture by Partners hospitals to use the Harvard name to drum up business overseas. It worked a little too well.
• Overconfidence:  Sure we have great hospitals here in Boston. But not everyone running a hospital overseas is an idiot; many understand their own health system and patient populations pretty well. When I visited Singapore hospitals I was struck by the openness of executives in speaking with me, and impressed with their approach to cost-effective, high quality care. The one exception was when I visited a Hopkins outpost there, where the staff were highly bureaucratic and unapproachable.  MGH and the Brigham will need to make sure what they take on is aligned with their true areas of differentiation and not just their self-perceptions.
• Ethical risk: Let's be honest. American values differ from those of the Persian Gulf and China. As just one example, anyone in Boston can show up at the emergency department of MGH or the Brigham and be treated, regardless of nationality, race, religion or ability to pay. Will that be the case in hospitals MGH and the Brigham work with overseas? If not, is that ok? What else needs to be considered?

I wish the MGH and Brigham well in their overseas forays, and do think it's a more fruitful approach than further expansion in Massachusetts. The Globe should have plenty more to write about as the strategies unfold.

Image courtesy of pakorn at FreeDigitalPhotos.net—

By healthcare business consultant David E. Williams, president of Health Business Group.