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Sanford/Fairview merger prompts concerns about patient care

Experts say the combined health system could lead to higher deductible costs and a lower quality of care.

MINNEAPOLIS — An announcement from this week, that the University of Minnesota plans to build a new, billion-dollar hospital, has piqued the interest of many. 

The school also wants to buy back its other medical facilities from Fairview Health Services - this after Fairview and Sanford Health announced plans to merge this year. 

But the mega-merger drew concerns Tuesday at a public hearing from doctors, union members and Phil Duran - a lawyer at Rainbow Health that advocates for aging and gender-affirming care. That care includes therapy, medications and surgery for people diagnosed with gender dysphoria. 

In a statement, a Fairview spokesperson says, "The combination will not impact abortion or gender-affirming care policies and practices for providers or the way patients access abortion or gender-affirming care."

"We appreciate that commitment, but there still seems to be a distance between Sanford and Fairview when it comes to this and I don't think anything came out at the meeting Tuesday night that changed our concern about that," said Duran.

Founded more than 100 years ago, Sanford is based in Sioux Falls, South Dakota and is known for serving rural populations.

It's already operating about 20 hospitals in Minnesota and the merger would more than double that - the two systems are also rooted in the Lutheran church.

"Fairview articulates its mission in purely secular terms right now, whereas one of the speakers pointed out, Sanford's mission statement mentions God twice and patients no times, and so what does that say, I don't know," said Duran. "What we do see is that in other contexts, institutions that identify with a particular religious tradition have been at the forefront of fighting efforts to provide care to LGBTQ folks and trans folks in particular."

Sanford doesn't have a corporate policy that addresses abortion, but a spokesperson said it "will provide medically-necessary abortions in accordance with applicable state and federal laws where they operate." 

That spokesperson also writing, "Sanford Health provides gender-affirming care and believes in providing inclusive care for every patient. For example, their Fargo medical center is nationally recognized as a top performer on the Healthcare Equality Index for providing equitable care for the LGBTQ+ community. Today (Friday), Sanford Health is hosting its third annual Gender Summit in Sioux Falls, South Dakota. The medical education event is designed to help providers meet the unique care needs of this population."

Except bigger doesn't always mean better - especially if you ask Allan Baumgarten, a healthcare market analyst. He says a merger is mostly meant to gain more market power. 

"The research on these mergers shows that, for the most part, it leads to increased prices, and is either indifferent or shows a slight decrease in patient care quality," said Baumgarten.

He added the move could raise co-payments, deductibles and premiums by as much as 10%.

Sanford has tried mergers before - once with Fairview 10 years ago and another four times with other health systems, including Allina. 

When asked if Baumgarten thinks this deal will go through he said, "I would give better odds of Sanford and Fairview going through if the University hospitals in fact separated out from the deal."

The University says it's still negotiating on whether it can buy back its medical facilities, as the Attorney Generals Office is also reviewing the merger. It's holding more public hearings across the state this month.

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