- The University of California San Francisco ended its pursuit of an expanded affiliation with Catholic health giant Dignity Health, citing community and staff pushback against a closer relationship with a system that's restricted women's reproductive options, care for LGBTQ+ individuals and end-of-life services such as physician-assisted suicide.
- UCSF Chancellor Sam Hawgood and CEO Mark Laret, who announced the change in a joint statement Tuesday, said they met with Dignity and UCSF leaders and staff in recent days before deciding to stop a greater relationship between UCSF and Dignity's four Bay Area hospitals.
- UCSF and San Francisco-based Dignity have worked together for two decades and will continue collaborating on hospital medicine, mental health, neurology, neurosurgery and pediatric burn care, among other patient services. UCSF did not shut down the potential of a larger relationship with Dignity in the future.
The expanded partnership died over some of the same issues recently making headlines. On Friday, the HHS Office of Civil Rights proposed a rule that, if finalized, would roll back anti-discriminatory protections for LGBTQ+ people, along with women seeking abortions.
That guidance is the latest move by the Trump administration to strip protections enacted under President Barack Obama. It follows a highly controversial "conscience rule" HHS finalized in May that would allow providers to deny medical care if it conflicts with their religious or moral beliefs.
The city of San Francisco, a coalition led by California Attorney General Xavier Becerra and a coterie of civil rights groups are suing the administration over the rule, alleging it could cause healthcare providers to do away with reproductive and LGBTQ+ services altogether over fear of potential noncompliance.
Catholic health systems have been in the spotlight over denying medical care to LGBTQ patients and women seeking contraceptives or abortions. Catholic-affiliated hospitals follow a series of "ethical and religious" directives restricting access to services, counseling and referrals — including for procedures such as elective abortions, surgical contraception, in vitro fertilization, gender-affirmation surgery for transgender people or end-of-life care such as physician-assisted suicide, which is legal in California.
The now-defunct relationship expansion between Dignity and public hospital UCSF didn't include a merger or one in which Dignity would have had a direct role at USCF facilities, according to an FAQ. Instead, the two providers held talks for three years on creating a stronger link between UCSF and four Dignity facilities in the Bay Area: Sequoia Hospital in Redwood City, Dominican Hospital in Santa Cruz and Saint Francis Memorial Hospital and St. Mary's Medical Center in San Francisco.
UCSF explored a tighter institutional bond due to space constraints at its own centers, Lori Freedman, a medical sociologist and associate professor of obstetrics and gynecology at UCSF, told Healthcare Dive — particularly for its labor and delivery services. UCSF already had smaller partnerships with three of the Dignity hospitals.
Under the deal, the two systems would share branding and governance with those four hospitals, granting UCSF inexpensive space for patient overflow and a stronger economic foundation while giving Dignity added income and a reputational boost, Freedman said.
"The specialty care [at UCSF] is world-renowned, so Dignity would have name recognition attached to their facilities along with the promise of UCSF quality of care," Freedman, who's been with UCSF for more than 11 years, said. "But UCSF also promises a full spectrum of care, not religiously-excepted care, so it gives an image that wouldn't be transparent or fully realized."
UCSF told Healthcare Dive it will continue to work with Dignity and look for a "viable path" that meets many of the issues flagged by those protesting the expanded partnership. Dignity also confirmed it remains committed to the existing partnership with UCSF.
"We are particularly sensitive to addressing the unique needs of women, LGBTQ patients, and those facing end-of-life decisions, as well as expanding access to welcoming and respectful healthcare," the UCSF execs said in a statement about why they decided to terminate the deal.
Dignity, one of the nation's largest health systems, was snapped up by Englewood, Colorado-based Catholic Health Initiatives in a merger that closed in February and created the largest nonprofit health system by revenue in the U.S. The joint company, called CommonSpirit Health, serves 21 states through more than 140 hospitals.
In November, California's attorney general dictated under the terms of the merger the combined health systems must provide a 100% discount for patients who earn 250% of the federal poverty level. And, to marry the more conservative CHI to Dignity, Dignity facilities must continue to provide reproductive health services for at least five years. After that, they can be phased out.