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.

And John Fernandez, president of Mass General Brigham Integrated Care, said the reason he is pushing for approval to open new ambulatory care centers in Woburn, Westborough, and Westwood is to provide care in a lower-cost setting. He said the Health Policy Commission would prefer patients continue to travel into Boston.

“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. 

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Bruce Mohl

Editor, CommonWealth

About Bruce Mohl

Bruce Mohl is the editor of CommonWealth magazine. Bruce came to CommonWealth from the Boston Globe, where he spent nearly 30 years in a wide variety of positions covering business and politics. He covered the Massachusetts State House and served as the Globe’s State House bureau chief in the late 1980s. He also reported for the Globe’s Spotlight Team, winning a Loeb award in 1992 for coverage of conflicts of interest in the state’s pension system. He served as the Globe’s political editor in 1994 and went on to cover consumer issues for the newspaper. At CommonWealth, Bruce helped launch the magazine’s website and has written about a wide range of issues with a special focus on politics, tax policy, energy, and gambling. Bruce is a graduate of Ohio Wesleyan University and the Fletcher School of Law and Diplomacy at Tufts University. He lives in Dorchester.

About Bruce Mohl

Bruce Mohl is the editor of CommonWealth magazine. Bruce came to CommonWealth from the Boston Globe, where he spent nearly 30 years in a wide variety of positions covering business and politics. He covered the Massachusetts State House and served as the Globe’s State House bureau chief in the late 1980s. He also reported for the Globe’s Spotlight Team, winning a Loeb award in 1992 for coverage of conflicts of interest in the state’s pension system. He served as the Globe’s political editor in 1994 and went on to cover consumer issues for the newspaper. At CommonWealth, Bruce helped launch the magazine’s website and has written about a wide range of issues with a special focus on politics, tax policy, energy, and gambling. Bruce is a graduate of Ohio Wesleyan University and the Fletcher School of Law and Diplomacy at Tufts University. He lives in Dorchester.

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.”