With new investments and affiliation agreements, Lifespan to become Brown University Health

Rhode Island's largest medical system changes its name

Brown University

 

Amid ongoing headwinds facing the health care sector, Lifespan health system and Brown University have finalized terms on a set of expanded affiliation agreements to strengthen top-quality patient care, medical education and biomedical research in Rhode Island.

As part of the agreements, Lifespan will change its name to Brown University Health later this year through a rebranding effort to be developed over the next several months, enhancing its ability to recruit and retain world-class physicians and reflecting a deeper alignment between Lifespan’s clinical care and Brown’s academic and research focus.

The agreements also include reciprocal financial investments between Lifespan and Brown, which will continue as separate, independent organizations after the implementation of the Lifespan rebrand to Brown University Health. A $15 million to $25 million annual investment from Brown to Lifespan, totaling $150 million over seven years, will be devoted to strengthening Lifespan’s financial capacity to sustain and advance the shared academic mission of the two organizations. Following that period, Lifespan will invest $15 million annually to support the Warren Alpert Medical School’s education and research efforts.

Lifespan President and Chief Executive Officer John Fernandez and Brown President Christina H. Paxson shared details on the new agreements in a Thursday, June 20, event at Hasbro Children’s Hospital. Fernandez said these continue to be difficult times in health care, and it is more important than ever that Lifespan solidify and strengthen ties between patient care delivery and Brown as its academic partner.

“We are excited to move forward with robust plans to expand our facilities and improve our systems and technology to be able to compete with new entrants to the health delivery market, such as national chains,” Fernandez said. “This enhanced relationship with Brown is one part of the solution to ensure that our health system can continue to offer the people of Rhode Island the opportunity to access high-quality treatment close to home.”

Brown University Health

An expanded affiliation between Brown and Lifespan is designed to strengthen patient care, medical education and biomedical research in Rhode Island.

Paxson said the agreements advance Brown’s goals to ensure that medical students, residents and fellows are learning from outstanding clinicians with opportunities to train using the latest technology and techniques. Brown’s investments promise to accelerate improvements including the expansion of electronic health records, and the recruitment of talented academic and clinical leaders as care providers and department chairs for Brown’s Warren Alpert Medical School and its affiliated hospitals.

“Brown and Lifespan are taking important steps to strengthen our longstanding affiliation with the goal of improving the health of families in Rhode Island, both through medical advances in care and state-of-the-art medical training for the next generation of physicians,” Paxson said. “These agreements also strengthen the work we have been doing for several years to integrate research and break down barriers for physicians and scientists who translate discoveries in the lab into treatments benefitting patients.”

The agreements follow votes by the Lifespan Board of Directors and the Corporation of Brown University, each of which approved a non-binding term sheet directing their leadership teams to negotiate an extension and expansion of the affiliation agreements between the organizations. Lifespan and Brown have long-standing affiliations, which designate Rhode Island Hospital as the principal teaching hospital for Brown’s Warren Alpert Medical School, the only medical school in the state. The affiliation dates back to 1969, before a four-year medical program was established at the University.

Investments in academic medicine

Fernandez said that in the face of a rapidly and ever-changing health care environment, the new agreements offer a timely and critical step to strengthen a Rhode Island-based health care delivery system and biomedical research structure. He asserted that the industry will likely confront significant headwinds for the foreseeable future, including inflation, labor shortages and low reimbursement rates. For Lifespan, lack of adequate funding over many years has hampered the ability to keep pace with necessary infrastructure investments, he said.

The agreements outline financial investments to address those challenges and establish deeper Brown-Lifespan collaborations in clinical care, medical education, population health, public health and biomedical research.

“It is critical that facilities, systems and technologies are not only modernized, but are cutting-edge in order to be able to compete with out-of-state companies, new entrants to the market and large national providers, particularly for-profit businesses,” Fernandez said. “Equally important is investing in workforce development to retain existing, first-rate clinicians and employees and to recruit future top talent. This enhanced relationship is one step in a broader effort to ensure that Rhode Island can continue to offer access to the highest quality medical treatments in a local setting while at the same time generating high paying job opportunities for years to come.”

The new agreements impact four broad areas:

(1) New Name: The health system will continue to use the name Lifespan in all of its business operations until its new name officially launches on a to-be-determined date, expected later this year, with the full rebrand taking several years to complete. The official rebranding of Lifespan to Brown University Health — to be referred to commonly as Brown Health — will help the health system recruit and retain physicians, grow research as a recognized academic medical center, and sustain a vibrant medical education program. This will reflect the ability to provide medical care of international caliber to Rhode Islanders, according to health system and University leaders.

“The new agreements move the relationship between Brown and Lifespan to a more contemporary model in line with other affiliation agreements we see across the country, where the academic-medical affiliation is reflected through a shared name between the hospital system and the academic institution,” Paxson said.

(2) New Financial Investments: Beginning July 1, 2024, Brown will make annual contributions of $15 million to $25 million — totaling $150 million over seven years — to support the mission of Lifespan. Following that period, Lifespan will invest $15 million annually for Brown’s medical school to support research and medical education, for the life of the agreement.

In addition, the Brown Investment Office will manage approximately $600 million to $800 million of Lifespan’s investment portfolio, creating the capacity for increased returns to support Lifespan’s mission. The portfolio will be phased in on a schedule expected to be about $200 million per year over four years.

“Lifespan and Brown have a vested interest in securing and furthering the academic mission of the state’s largest health care system, which is critically important to both organizations’ continued long-term success,” Fernandez said. “Solid financial footing is needed now to address facilities and other infrastructure needs across the Lifespan system, and our longer-term support will in turn help to further recruit and retain talented academic and clinical leaders as department chairs for the Warren Alpert Medical School."

Examples of mission-oriented Lifespan activities and strategic initiatives the funds will be used for include:

• Recruiting physicians to improve access to care for more Rhode Islanders and to attract more patients to come to Rhode Island for care. Increasing out-of-state patient services revenue will help Lifespan offset local costs, while also increasing the number of well-paying health care jobs for Rhode Islanders.
• Investing in state-of-the-art facilities for training world-class physicians and conducting innovative biomedical research in support of a revitalized, resilient and reliable health care system in Rhode Island.
• Continued investment in programs that improve the health, welfare and economy of underserved communities locally. The Lifespan Community Health Institute offers hundreds of programs, events and community service activities serving tens of thousands of southern New Englanders annually. This investment will help Lifespan continue its work to eliminate health disparities and promote health equity through healthy behaviors, healthy relationships and healthy environments.
• Expanding the reach of the Lifespan electronic health record (EPIC). This will allow patients, physicians and medical students to view records for primary care, hospital, specialty, laboratory and imaging services in one portal, enabling more coordinated care by providers, and enhancing the accessibility of health data approved for use in research to improve patient care.

“The investments from Brown are critical and will help Lifespan address its immediate challenges,” Fernandez said. “Lifespan will still need to continuously improve its operations while expanding and diversifying its revenue opportunities and work toward creating a more balanced reimbursement structure on par with those of neighboring states.”

(3) Enhanced Academics and (4) Governance: The agreements establish that the Warren Alpert Medical School dean will serve as Lifespan’s chief academic officer. In addition, the president of Brown and the dean of its medical school will become ex officio members of Lifespan’s Board of Directors.

The agreements also formalize a series of terms around academic affiliations:

• Rhode Island Hospital will continue to be formally designated as the principal teaching hospital of the Warren Alpert Medical School, recognizing the scope and critical mass of teaching and research activities centered exclusively at Rhode Island Hospital. The other Lifespan teaching hospitals (The Miriam Hospital and Bradley Hospital) will continue to be designated as major teaching affiliates. In addition, Newport Hospital will serve as a community affiliate.
• The Warren Alpert Medical School will be the exclusive medical school affiliate of Lifespan, and Lifespan will continue to be the home of 11 of the medical school’s clinical departments. Family medicine, OBGYN and psychiatry academic and clinical chairs will continue to reside at Care New England’s Kent, Women & Infants and Butler hospitals. Brown will also maintain its strong academic affiliation agreements with Care New England, the Providence V.A. Health System, HopeHealth and Brown Physicians, Inc. for teaching, faculty development and research.
• Lifespan will continue to be affiliated with other educational institutions (such as the University of Rhode Island, Rhode Island College and Community College of Rhode Island) for clinical education programs not currently offered at Brown.


Aligning strengths

Leaders from Lifespan and Brown said the agreements reflect a shared commitment to aligning the strengths of both organizations and bolstering connections across delivery of care, medical training and biomedical research.

“We are confident that this comprehensive, collaborative approach and mutual commitment to serving the needs of the people of Rhode Island will bring value to this community and help build a healthier, more vibrant state,” Fernandez said.

Lifespan and Brown are not merging, neither organization will purchase any part of the other, and they will remain separate and independent. For these reasons, the enhanced agreements did not require regulatory or legislative approval. Lifespan and Brown leaders noted they engaged the Rhode Island Department of Health and Office of the Attorney General, and said they appreciated the efforts of both agencies in conducting separate reviews. This included fruitful discussions with the Attorney General, who confirmed that no further regulatory review is required at this time.

“We are sustaining efforts to capitalize on each organization’s existing strengths, strategically build research capacity, coordinate effectively with other local institutions, and create new partnerships that benefit the people and economies of Rhode Island,” Paxson said.