Ascension (company)

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]

Ascension
TypeNonprofit organization
IndustryHealthcare
Founded1999 (1999)
HeadquartersSt. Louis, Missouri,
U.S.
Number of locations
151 hospitals
Key people
Joseph R. Impicciche, CEO
ServicesHospital management
Number of employees
150,000 (2019)
Websitewww.ascension.org

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 Wheaton Franciscan Services (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]

Project Nightingale

In 2018, controversy swirled around an announcement by Ascension and data-mining giant 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.[12][13][14][15] It also sparked inquiries by three U.S. Senators.[16]

Google and Ascension officials defended the program as beneficial.[17][18] 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.”[19]

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.[12][19][20][21]

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] A partial listing of Ascension sites, based on a press release noting that these hospitals were among those cited as "Most Wired" in the 19th Annual list of "Health Care's Most Wired", derived from a survey by the Health Forum of the American Hospital Association:[22]

  • AMITA Health, Illinois
  • Ascension Calumet Medical Center, Chilton, Wisconsin
  • Ascension Mercy Medical Center, Oshkosh, Wisconsin
  • Ascension Saint Clare's Hospital, Weston, Wisconsin [sold by Ascension, 2020][23]
  • Ascension St. Elizabeth Hospital, Appleton, Wisconsin
  • Borgess Health, Kalamazoo, Michigan
  • Columbia St. Mary's Hospital, Milwaukee
  • Providence Health System, Mobile, Alabama
  • Sacred Heart Health System, Pensacola, Florida
  • Saint Thomas Health, Nashville, Tennessee
  • Seton Healthcare Family, Austin, Texas
  • St. Vincent Health, Indiana
  • St. John Health System, Tulsa, Oklahoma
  • St. John Providence, Warren, Michigan
  • St. Mary's Healthcare, Amsterdam, New York
  • St. Vincent's Health System, Birmingham (Blount, Oneonta, East, and Pell City), Alabama
  • Via Christi Health, Wichita, Kansas

See also

References
  1. "Largest hospitals and health systems in America | 2019". Beckers Hospital Review. Retrieved 2020-03-24.
  2. "Our History". www.ascension.org. Retrieved 2020-03-24.
  3. "As Ascension restructures, it hints at smaller hospital footprint," March 22, 2018, Modern Healthcare, retrieved March 30, 2020
  4. Drucker, Jesse; Silver-Greenberg, Jessica; Kliff, Sarah (2020-05-25). "Wealthiest Hospitals Got Billions in Bailout for Struggling Health Providers". The New York Times. ISSN 0362-4331. Retrieved 2020-05-25.
  5. Doyle, Jim. "How a St. Louis-based health care system became one of the nation's biggest". STLtoday.com. Retrieved 2020-03-24.
  6. "Ascension is unwinding its ownership role in Health City Cayman Islands". Catholic Health Association of the United States. Retrieved 2020-03-24.
  7. "Federal judge approves Ascension Health's $29.5M settlement in class-action pension lawsuit," January 18th, 2018, Becker Hospital Review, retrieved March 30, 2020
  8. "Ascension sued by city officials to keep DC health system open," retrieved March 30, 2020
  9. "Providence Hospital on track to close as D.C. drops lawsuit,". The Washington Post. March 12, 2019. Retrieved 30 March 2020.
  10. D'Ambrosio, Amanda, "Doc Wins $4.75M in Fraud, Defamation Case Against Hospital — Ob/gyn said she was wrongly accused of substance abuse," February 5, 2020, MedPage Today, retrieved March 30, 2020
  11. Stafford, Dave, "Jury finds against St. Vincent’s, awards wrongly accused doctor $4_75 million," January 17, 2020, The Indiana Lawyer, retrieved March 30, 2020
  12. "Google to Store and Analyze Millions of Health Records: The tech company’s deal with Ascension is part of a push to use artificial intelligence to aid health services," November 11, 2019, The New York Times retrieved March 30, 2020
  13. "Google, Ascension data partnership sparks federal probe," November 13, 2019, Modern Healthcare, retrieved March 30, 2020
  14. "Google Confirms it has Legitimate Access to Millions of Ascension Patients’ Health Records," Nov 12, 2019, HIPAA Journal, retrieved March 30, 2020
  15. "Inside Google’s Quest for Millions of Medical Records: The company has struck deals that grant it access to troves of patient data; 'We want to be helpful'," January 11, 2020, The Wall Street Journal, retrieved March 30, 2020
  16. Lovett, Laura "US senators question Ascension on its Google collaboration Project Nightingale: Elizabeth Warren (D-MA), Richard Blumenthal (D-CT) and Dr. Bill Cassidy (R-LA) sent a follow-up letter to Ascension CEO Joesph Impicciche regarding privacy concerns about Project Nightingale," March 04, 2020, MobiHealthNews, retrieved March 30, 2020
  17. "Google Health Exec Defends Controversial Partnership With Ascension: ‘We’re Super Proud Of It'," Jan 14, 2020, Forbes, retrieved March 30, 2020
  18. "Google Health VP on Ascension partnership: 'The press has made this into something it's not': In a candid conversation on stage at the Startup Health Festival, Dr. David Feinberg said his company was doing good and playing by the rules," January 17, 2020, Healthcare IT News, retrieved March 30, 2020
  19. "Google Is Slurping Up Health Data—and It Looks Totally Legal: Tech giants can access all of your personal medical details under existing health privacy laws. The question is how else that data might get used," November 11, 2019, Wired, retrieved March 30, 2020
  20. Davis, Jessica, "Google Ascension Partnership Fuels Overdue HIPAA Privacy Debate: Reports on Ascension teaming with Google on "Project Nightingale" have sparked public outcry, but the partnership shines a light on the need to improve HIPAA to better reflect the data privacy expectations of consumers," December 02, 2019, Health IT Security, retrieved March 30, 2020
  21. "Google 'Project Nightingale' hospital data deal raises privacy fears," November 12, 2019 CNBC, retrieved March 30, 2020
  22. "Ascension Hospitals Well Represented on 2017 ‘Most Wired’ List," retrieved March 30, 2020
  23. "Ascension inks definitive agreement to sell 2 Wisconsin hospitals," February 19th, 2020, Becker Hospital Review, retrieved March 30, 2020
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