STATE HOUSE — Dr. Abha Agrawal took the helm of Lawrence General Hospital this winter and soon had a crash course in the state’s tumultuous health care landscape.
Agrawal came to the Merrimack Valley after serving as chief medical officer at Humboldt Park Health in Chicago, where she said she helped transform a hospital on the brink of closure and bankruptcy.
“I came here in January. Pretty [much] a couple of days out, I didn’t know about Steward Health Care or Holy Family hospitals for that matter, for sure,” Agrawal said at a Massachusetts Health and Hospital Association webinar Thursday. “Of course as a new CEO, you are not only inward looking, evaluating, assessing what your strengths and weaknesses are, but also trying to understand your health care landscape, comparative landscape around you very quickly. Within a few days, the news about Steward started to escalate, and I’m like, ‘OK, how does it impact us?’”
Through the Steward bankruptcy process, Lawrence General acquired and took over operations at Holy Family Hospital, which has campuses in Haverhill and Methuen. Agrawal said she now envisions creating a regional health care system that provides high-quality, culturally competent and equitable care.
In her new role, Agrawal said she soon learned that the Methuen campus was 1.6 miles away from Lawrence General, while the Haverhill facility was 6.8 miles away. As she phrased it, those hospitals were in Lawrence General’s backyard.
“Here is what was very clear to us: We could not stand by and say it’s not a problem with Steward, whatever happens there. Any abrupt closure would have had tremendous impact on us, right?” Agrawal said. “We do 65,000 visits a year. Between those two campuses — about 45,000 visits a year at Methuen and 20,000 visits a year at Holy Family Haverhill — so about the same number of ER visits. No campus has the physical capacity or workforce capacity to absorb all of it.”
Closing those hospitals would have also caused a “catastrophic impact” on maternity care, she said. Agrawal added, “It was very clear to me that the closure of these hospitals would be disastrous for patients and organizations.”
Health care providers were also wary about disruptions to patient care if another for-profit company like Steward came into the Merrimack Valley and bought Holy Family, she indicated. Ultimately, Lawrence General pursued “this almost audacious and improbable idea” to create a regional health care system, Agrawal said.
Agrawal said the system’s future won’t be easy, as Lawrence General grapples with Steward’s “foundational sin” of stripping resources away from hospitals. She made no direct mention of ousted Steward CEO Ralph de la Torre, who managed to buy private jets and yachts while the company’s community hospitals floundered.
“I can speak firsthand about the two campuses of Holy Family Hospital and using those resources for personal profit and dilapidating, absolutely depleting these facilities of any resources,” said Agrawal, who described making rounds on clinical floors. “I see how dedicated the staff are, but how poorly maintained from an equipment perspective. I mean, we just learned an MRI machine isn’t working because they did not replace the helium.”
To stabilize the Holy Family hospitals, Agrawal outlined work ahead to ensure the facilities deliver safe care and have adequate equipment, and receive “fair” reimbursements and investments in order to care for underserved communities. Massachusetts has committed at least $417 million over the next three years to support former Steward hospitals while they transition to new owners.
Providers are also trying to rebuild trust among patients in the region, Agrawal said.
“It’s going to be a tremendous amount of work, but we are driven by this vision of creating a system of scale and stability for the next generation to come,” she said.
“And I also keep another sort of vision in my mind: If not this, how disastrous the alternatives could have been for this community. So on the one hand, it’s a great positive vision, but something that’s absolutely, that was just needed.”