The Mass General Brigham debate goes on
Hospital officials, AG appeal to DPH
THE HEALTH POLICY COMMISSION’S double-barreled attack on Mass General Brigham dominated the headlines earlier this week, but the truth is the commission — as influential as it is — is just one of many players trying to convince the state Department of Public Health to either approve or reject the hospital system’s $2.3 billion expansion plan.
Three top Mass General Brigham officials made that point exactly in letters they sent to the Department of Public Health on Thursday. They said DPH should consider the Health Policy Commission’s perspective, but not give it any greater weight than a separate analysis commissioned by the agency (and paid for by Mass General Brigham) that reached a very different conclusion. They also urged DPH to remember that its mandate is much broader than the Health Policy Commission’s.
“The HPC’s role is narrow – to contain monetary health care costs,” said David Brown, the president of Massachusetts General Hospital, which is seeking approval to expand. “The HPC does not consider the benefits of a project from the access or quality perspectives. But that is, in fact, DPH’s role, and it is critical that the DPH not lose sight of its broader purpose in determining what is needed for the good of public health.”
David McCready, the president of Brigham and Women’s Faulkner Hospital, which is also seeking to expand, made a similar point in his own letter. “The HPC’s analysis was designed to reach its predetermined conclusion that patients should not have a choice with respect to their own health care if the costs of such care may be higher than that offered by another provider,” McCready said.
“According to the HPC, if MGB patients don’t like the inconvenience, they can use local non-MGB providers,” he wrote. “The HPC would remove MGB patients’ choice and direct them to providers that they do not choose to use, which is equivalent to government directed, rationed care.”
Attorney General Maura Healey’s office, another player in this high-stakes hospital drama, sent a letter to the Department of Public Health on Thursday focusing on deficiencies in the cost analysis that concluded the Mass General Brigham expansion plan was consistent with the state’s health care cost containment goals.Eric Gold, the head of Healey’s health care division, said the analysis failed to take into account the power of the Mass General Brigham brand in attracting patients. Calling Mass General Brigham “among the finest health care provider systems in the world,” Gold said many who try Mass General Brigham for one form of care will eventually go all in.
“These patients will be creating a relationship with the MGB system that will (or may) likely involve long-term shifts in where they obtain primary, specialty, and hospital care,” Gold wrote. “Analysis of the project’s impact on the Commonwealth’s health care cost containment goals is not complete without considering the financial impact of the shift of commercially insured patients to the MGB system for all their care. In its 2018 planning process, MGB itself anticipated that creation of new ambulatory care centers would increase patient affiliation with the whole MGB system and would generate referrals to MGB hospitals.”