Ascension (healthcare system)

Ascension is one of the largest private healthcare systems in the United States, ranking second in the United States by number of hospitals as of 2019.^[1] It was founded as a nonprofit Catholic system.^[2]

In 2018, it was the largest Catholic health system, with 165,000 employees, 151-hospitals, and $552.69 million in income from operations on revenue of $22.63 billion. Ascension's CEO in 2018 was Anthony Tersigni.^[3]

Ascension has $15.5 billion in cash and operates a venture capital fund.^[4]

History[]

In 1999, the Daughters of Charity National Health System and Sisters of St. Joseph Health System merged to create Ascension Health, which was later renamed to Ascension; over the years, various other hospitals and clinics joined the system.^[2]

In 2014, the company partnered in opening the $2b Health City Cayman Islands project,^[5] and sold its stake in 2017.^[6]

In April 2016, a class-action lawsuit was brought in federal court, alleging that Ascension subsidiary (in Glendale, Wisconsin), erred by treating its pension plan as though it was a "church plan," exempt from the Employee Retirement Income Security Act ("ERISA"), a federal law governing employee pensions. In January, 2018, the parties announced a settlement, in which Ascension would pay $29.5 million to the plaintiffs.^[7]

In December 2018, the Attorney General of the District of Columbia brought suit against Ascension in an attempt to prevent its closure of Providence Health System hospital, which served a low-income population, and had failed financially. The suit alleged that the closure was in violation of the hospital's license.^[8] Though the D.C. city council passed an ordinance giving the Mayor the power to block the closing, the suit ultimately failed—with the Council blamed by the judge for acting too slowly—and the hospital closed.^[9]

In February, 2020, a jury awarded obstetrician/gynecologist Rebecca Denman, MD, $4.75 million in damages by an Indiana jury, after suing Ascension's St. Vincent Carmel Hospital and its St. Vincent Medical Group for defamation and fraud. The lawsuit arose from a December 2017 incident, in which Denman was accused of smelling like alcohol while on duty. Denman contended that she had been cheated out of the due process, as provided in the company substance-abuse policy, depriving her of a chance to establish her innocence, and retain her position.^[10][11]

In October 2021, Ascension and AdventHealth announced the planned dissolution of their joint venture AMITA in 2022. Each system will retain the hospitals they originally contributed to the partnership. ^[12]

Project Nightingale[]

In 2018, controversy swirled around an announcement by Ascension and Google, that they had agreed to share information on millions of Ascension patients. The project, internally known as "Project Nightingale," involved analyzing health data—including lab results, medications, and diagnoses of Ascension patients—to use Google's artificial intelligence resources to recommend changes in a patient's care (different diagnostic tests, treatment plans, or additional physicians) and flag unexpected deviations in that care. The announcement sparked a probe by the Office for Civil Rights of the U.S. Department of Health and Human Services, which enforces the Health Insurance Portability and Accountability Act (HIPAA), the principal law governing the privacy of patient records in the United States.^{[13][14][15][16]} It also sparked inquiries by three U.S. Senators.^[17]

Google and Ascension officials defended the program as beneficial.^[18][19] Google Cloud president Tariq Shaukat posted a blog note asserting that Ascension health data would not be combined with consumer data, nor would it be used beyond the scope of Google's contract with Ascension—but the actual scope of that contract remained rather unclear. Shaukat wrote that the project includes moving Ascension's computing infrastructure to the Google cloud, as well as providing unspecified “tools” that would enable “doctors and nurses to improve care.”^[20]

Privacy advocates, however—along with cybertechnology and healthcare information technology experts—warned that Project Nightingale's risks to patient privacy may be massive, with the patient records tagged by patient name and date of birth, potentially allowing a direct correlation with other records in Google's vast database, for "other" uses outside the very limited protections of HIPAA.^{[13][20][21][22]}

Business model[]

In 2018, amid dwindling profit margins, Ascension announced plans to restructure and pursue a new strategic direction, with hints that it hoped to transition away from a hospital-oriented business, to a business prioritizing outpatient care and telemedicine—a new "advanced strategic direction" unanimously endorsed by its board of directors—a response to dwindling reimbursements from government and insurance providers; increasing regulatory hurdles; escalating pharmaceutical costs; industry shifts from inpatient to outpatient care models, and from fee-for-service models to value-based care models; and in response to increasing competition.^[3]

Sites[]

The Ascension network, in 2018, included 151 hospitals.^[3]

• AMITA Health, Illinois
• Ascension Calumet Medical Center, Chilton, Wisconsin
• Ascension DePaul Services, San Antonio
• Ascension Mercy Medical Center, Oshkosh, Wisconsin
• Ascension Michigan, Warren, Michigan
• Ascension Providence, Mobile, Alabama
• Ascension St. Elizabeth Hospital, Appleton, Wisconsin
• Brighton Hospital, Brighton, Michigan
• Centro San Vicente, El Paso, Texas (community health center)
• Columbia St. Mary's Hospital, Milwaukee
• Lourdes Hospital, Binghamton, New York
• Providence Healthcare Network, Waco, Texas
• Sacred Heart Health System, Pensacola, Florida
• Saint Agnes Hospital, Baltimore, Maryland
• Saint Thomas Health, Nashville, Tennessee
• Seton Healthcare Family, Austin, Texas
• St. John Health System, Tulsa, Oklahoma
• St. Vincent Health, Indiana
• St. Vincent's HealthCare, Jacksonville, Florida
• St. Vincent's Health System, Birmingham (Blount, Oneonta, East, and Pell City), Alabama
• Via Christi Health, Wichita, Kansas

See also[]

• Project Nightingale
• Ascension Michigan

References[]