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HPC Statement on Concluding Review of Steward Physician Network Sale

BOSTON —  Friday, October 11, 2024 — The Massachusetts Health Policy Commission (HPC) has concluded review of the sale of Steward Health Care’s physician network, Stewardship Health, which employs and contracts with insurers on behalf of primary care physicians and other clinicians across nine states, to Brady Health Buyer, an affiliate of Rural Healthcare Group (RHG) and subsidiary of Kinderhook Industries. The sale was approved by Judge Christopher Lopez on August 22, 2024, in the U.S. court overseeing the bankruptcy of Steward Health Care. 

The HPC’s preliminary review of the sale assessed potential impacts on health care costs, quality, access, and equity. Based on the findings of this data-driven review, and in order to maintain access to critical services and to provide greater stability to the health care market in Massachusetts, the HPC has elected not to proceed with further review in the form of a Cost and Market Impact Review (CMIR). This transaction was also subject to federal review, which was previously concluded. 

While the transaction presents uncertainties, as RHG is a young organization and a new private-equity backed entrant to the Massachusetts market, the HPC found that the immediate sale to RHG would allow Stewardship providers to continue to provide care for their patients, providing stability for patients, staff, and the health care market at large. Further, RHG has committed to continuing its participation in MassHealth, maintaining continuity of care for these patients. 

The HPC found limited potential for negative impacts on spending and market dynamics in Massachusetts, as the transaction will not increase Stewardship’s physician market share. The HPC analysis did not find that this transaction is likely to have negative impacts on quality of or access to services in Massachusetts. 

The HPC plans to closely monitor RHG’s operation of Stewardship going forward. In connection with the HPC’s review, RHG committed to fully complying with state transparency and market oversight efforts, including participation in the annual health care cost trends hearings and prompt registration with the Registration of Provider Organizations (RPO) program, which will allow for ongoing transparency of RHG’s operations in Massachusetts. RHG also committed to providing regular updates to the HPC on its operations in Massachusetts over the next two years, including on personnel changes, changes to services, patients served, and significant financial activities that could impact operations in Massachusetts. 

Along with the recently closed reviews of the Steward hospital transactions, this concludes the HPC’s reviews of transactions related to the bankruptcy of Steward Health Care. 

The HPC’s analysis was discussed at the HPC Board Meeting on Thursday, October 10, 2024. A recording of that meeting and presentation materials can be found on the HPC’s website.  

More information on the HPC’s market oversight authority and transaction review process can be found here.  

Massachusetts Health Policy Commission

The Massachusetts Health Policy Commission (HPC) is an independent state agency charged with monitoring health care spending growth in Massachusetts and providing data-driven policy recommendations regarding health care delivery and payment system reform. The HPC’s mission is to advance a more transparent, accountable, and equitable health care system through its independent policy leadership and innovative investment programs. The HPC’s goal is better health and better care – at a lower cost – for all residents across the Commonwealth.