IN AND AROUND Boston, the quality of our hospitals and the talent of our doctors, nurses, and medical personnel has never been in doubt. Rather, the question has always been whether patients can access that care affordably.
To address this goal, Mass General Brigham introduced a plan last year to open ambulatory care centers in Woburn and Westborough and expand a center in Westwood. The idea is straightforward enough: by bringing care, including expanded behavioral health services, to more of our patients where they live, we could lower the cost of care. Given the strain on hospital capacity resulting from the COVID-19 pandemic, coordinating care and moving outpatient care from large hospitals—like the Massachusetts General and Brigham and Women’s Hospitals, which care for the very sickest patients—and into the community not only makes sense but, according to a recent survey, is what 75 percent of our patients want.
As with any change to our health care system, questions are rightfully raised. Will these ambulatory centers lower the cost of care? Will there be an impact on other providers who also play an important role in our health care system? And, how were the locations for the new centers chosen?
With recently published results of a thorough and detailed independent cost analysis that was required as part of a Department of Public Health regulatory review, we now have answers to these questions. So, let’s take them one by one.
The first and perhaps most important question: will these centers lower the cost of care? The independent cost analysis found that these centers will meaningfully reduce costs for Mass General Brigham patients. For example, according to the report, patients receiving a CT scan at another Mass General Brigham facility today would see costs go down between 25 to 35 percent by switching to the Westborough center. In Woburn, the cost of outpatient surgery for a Mass General Brigham patient would drop by as much as 35 percent. Overall, the independent cost analysis concluded the cost of providing care for Mass General Brigham patients who switch to these centers would decrease between 16 and 37 percent.The second question: will there be an impact on other providers? To be very clear, the purpose of these new centers is to serve the 227,000 existing patients who live outside of Boston and currently have no choice but to drive into the city to get Mass General Brigham care in expensive hospital settings. The independent cost analysis found the predicted changes in Mass General Brigham’s market share would be “modest,” and the vast majority of patients would be “simply switching their site of care from an existing MGB facility” to a new community-based setting.
The third question: how were the locations for the new centers chosen? Once again, in an effort to lower cost and make receiving care more convenient for our existing patients, we need to meet our patients where they live. While some have questioned the diversity and wealth of these communities, according to the latest census data 35 percent of the population in Westborough identifies as being people of color, and it is a community that is more easily accessible by public transportation for patients living in neighboring towns. Meanwhile, Woburn has a relatively modest per capita income of about $43,000.
The final question not being asked is: where is the opposition coming from? Interestingly, the opposition is being led by a for-profit provider. According to public filings, the group named the “Coalition to Protect Community Care” was organized by and is headquartered in the offices of the for-profit Shields HealthcareGroup, which has annual revenues of $200 million. For-profit companies are obligated to their own bottom-line profit. Mass General Brigham, a non-profit, is committed to caring for all patients who need us and to conducting medical research that drives life-saving cures.
The two other charter members of this coalition represent competing providers — Wellforce, a 13,000 employee Massachusetts health system, and UMass Memorial Health, which bills itself as “the largest health care system in Central Massachusetts.” So, the loudest voices in opposition are not small community providers, as their coalition’s name suggests, but, in fact, large, established systems seeking to protect their own market share.
Bringing our existing doctors closer to where their patients live and lowering the cost of their care is not just the right thing to do. It’s what our patients want and what the data shows us they need. Today, with hospitals across the state struggling with capacity issues due to the one-two punch of delayed care and the Omicron variant, one thing is clear: patients deserve more access to care, not less. Now is the time to expand access to care, not restrict it.John Fernandez is president of Mass Eye and Ear, a member hospital of Mass General Brigham and a teaching hospital of Harvard Medical School, and president of Mass General Brigham Integrated Care.
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January 23, 2022 at 08:41AM
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