Steve Walsh raises concerns about urgent care clinics

The president and CEO of the Massachusetts Health & Hospitals Association downplayed the recent outpatient expansion proposal of Partners HealthCare and said the real concern is the rapid growth of urgent care facilities across the state.

On a Health or Consequences episode of the CommonWealth Codcast, Steve Walsh said the Partners outpatient expansion will receive a rigorous regulatory review. But he said a bigger concern is the growth of unaffiliated urgent care providers like the CVS Minute Clinics.

“There has long been a question as to are the unaffiliated urgent care ambulatory surgery centers helping to fund CHIA, the Center for Health Information and Analysis; the Health Policy Commission; and community benefits? Do they accept Medicaid? Are they treating our poorest and most vulnerable residents? Are they doing the same kind of programs for the opioid epidemic as our traditional hospitals are? So the real problem isn’t necessarily the expansion by one member into other communities. It’s all of the other expansion that’s happened over the last decade and what that has done to not create a level playing field for our members and for the community residents they serve.”

Paul Hattis of Tufts University School of Medicine and John McDonough of the Harvard Chan School of Public Health peppered Walsh with questions about a series of current health policy issues. He said he tries to respond to issues based not on how they affect his association’s 70 member hospitals, but on how they affect the patients those institutions treat.

“The issues really apply to everyone, whether they’re large or small,” he said. “We don’t say, well, how big is this member so we’ll look at this issue differently. We look at the patient.”

On the proposed merger of Harvard Pilgrim Health Care and Tufts Health Plan, Walsh said he needed more data before reaching a conclusion. He took much the same approach on recent data from the Health Policy Commission suggesting that the shift to outpatient care doesn’t always save money because more and more patients are shifting to Partners outpatient facilities, which tend to charge more for outpatient surgeries than other hospitals bill for in-hospital procedures.

On the legislative front, the former state lawmaker backed efforts to create more transparency around pharmaceutical pricing and hailed Gov. Charlie Baker’s proposal to shift health care spending more in the direction of behavioral health and primary care as “an incredible move in the right direction.”

As the drafter of the law that created the Health Policy Commission, he said he wished he had put pharma under its purview (“at the time we weren’t sure we were able to”) and included provider and payer stakeholder voices on the commission.

He gave a measured response to the state’s push in to managed care — a shift from compensating health providers based on the services they supply to paying them based on the overall quality of care they provide to a patient.

“I for one am aspirational about this,” he said. “I believe that a move to value-based care is critically important. I believe treating the whole person and doing it in a different way is the future of health care. I don’t think there’s any other way we can go.”

But Walsh said the value-based compensation is still largely based on a fee-for-service system. “I share a frustration that 10 years on we’re not further along,” he said.

He also said the shift by MassHealth, the state’s Medicaid program, into value-based care with 17 accountable care organizations is moving in the right direction but he insisted it’s not a panacea. Health care remains very expensive, he said.

“It is still a little early to tell, but it’s clearly something everyone is committed to. The administration, [Health and Human Services] Secretary Marylou Sudders, Gov. Baker, [Assistant Secretary] Dan Tsai, are really doing an incredible job of trying to make it work because this is the future.”

He declined to give the effort a grade.  “We’re above average but there’s always room for improvement,” he said.

SARAH BETANCOURT


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BEACON HILL

The Globe’s Matt Stout takes stock of the reign of Robert DeLeo as he becomes the longest-serving House speaker in state history. As with this lengthy 2016 CommonWealth profile of the speaker, who rules the House with an iron fist, DeLeo declined to be interviewed for the Globe story.

MUNICIPAL MATTERS

LGBT bereavement support groups provide solace when loved ones dies in Barnstable and Hyannis (Cape Cod Times)

The New Bedford Public Library has a Wash & Read program, stocking several laundromats in the city with children’s books and hosting story hours. (Standard-Times)

Local police are preparing to enforce a new Massachusetts law that bar taking a call, using a GPS, or any other hands-on cell phone use. (Patriot Ledger)

ELECTIONS

One day before the New Hampshire primary there is a sense of disarray and division among Democrats, with polls indicating Bernie Sanders and Pete Buttigieg are poised to lead the balloting in the first-in-the-nation primary. (New York Times) Buttigieg has gained rapidly and is now in a statistical dead-heat with Sanders, according to a final primary poll from Franklin Pierce University for the Boston Herald and NBC10 Boston. (Boston Herald)

BUSINESS/ECONOMY

Ann Klee, the former General Electric executive who led the search for a new headquarters that landed the company in Boston, was named executive vice president overseeing national business development and for government affairs at Suffolk Construction. (Boston Globe)

High winds toppled several shipping containers stacked at the state pier on Friday, knocking out power to the Braga Bridge, damaging a Battleship Cove building, and making one close call for city building inspectors on site to assess the damage, Fall River officials said. (Herald News)

EDUCATION

Don’t mess with the success of voc tech schools, say Tom Birmingham of the Pioneer Institute and Tim Murray of the Greater Worcester Chamber of Commerce, who argue against any move away from selective admissions to a lottery system for awarding voc school seats. (CommonWealth)

Sarah Rocha asks Boston Mayor Marty Walsh to approve a new high school building for her son’s school, Roxbury Prep Charter School. (CommonWealth)

John Gatto and Corey Prachniak-Rincon  of JRI ask why sex education hasn’t changed in 20 years. (CommonWealth)

TRANSPORTATION

If only we had kept following Frank Sargent’s lead in dealing with our car-centric culture, says former transportation secretary Jim Aloisi, maybe we wouldn’t have the congestion we face today. (CommonWealth)

Activists and advocates are voicing misgivings about plans for the reconstruction of a stretch of the Massachusetts Turnpike in Allston. (Boston Globe)

An MBTA worker was killed in a bus accident at the Quincy Center Station, but T officials have provided few details. (WBUR) The Patriot Ledger identified the woman who died, apparently when the unmanned bus rolled over her.

The head of the Brockton Area Transit Authority, Michael Lambert, responded to questions about eliminating fares on any of the city’s 16 bus routes. (The Enterprise)

Keep your promises, MBTA, says Mike Vartabedian of the machinists union. (CommonWealth)

ENERGY/ENVIRONMENT

The North Atlantic right whale is on the verge of extinction, with humans largely the cause of their vanishing numbers. (Boston Globe)

CRIMINAL JUSTICE/COURTS

The state Department of Correction says it was responding to “credible threats” of further violence at Souza-Baranowksi Correctional Center when it temporarily restricted inmate access to lawyers and confiscated legal documents from prisoners. (Boston Globe)