WESTBOROUGH – Mass General Brigham (MGB) leaders provided an update on a proposed expansion in Westborough to Select Board members in a meeting earlier this month.
Those Select Board members reiterated their support for the project and reacted to an analysis by the Health Policy Commission during their Feb. 8 meeting.
The ambulatory care clinic is slated to open in the summer of 2023, according to Mass Eye and Ear President and MGB Integrated Care President John Fernandez’s presentation to the board.
The clinic is one of multiple proposed new facilities that MGB is seeking to open in Massachusetts.
In the meantime, MGB’s project is going through the Massachusetts Department of Public Health’s Determination of Need process. Under the law, proposed expansions of health care providers, like this project, are subject to a state process to decide whether the proposal is in the public’s best interest.
Last March, the program notified MGB that it was requiring an independent cost-analysis (or ICA).
Released in December, that analysis found that the MGB expansion would lead to a slight decrease in overall health care costs for services provided at the proposed Westborough clinic.
The Health Policy Commission, which is an independent state agency that monitors health care spending, also conducted its own analysis, though.
“The HPC’s analyses show that these proposals are likely to drive substantial patient volume and revenue to the higher-cost MGB system — particularly commercially insured volume — resulting in increased health care spending, increased commercial insurance premiums, and a negative impact on the health care market functioning, including access and equity,” the HPC wrote in its public comment last month.
The HPC is estimating that the projects are likely to increase annual health insurance spending in the state by between $46 and $90.1 million, shifting “substantial” revenue to MGB and away from other providers.
The HPC is now requiring MGB to develop a performance improvement plan that the commission said would result in “meaningful, costsaving reforms.”
Fernandez responded to criticism of this project, saying that comments that MGB isn’t taking care of lower-income patients are false.
“At MGB, we take care of more Medicaid patients than anybody else in the state,” he said.
Critics note opposition
Criticism of MGB’s efforts has abounded, at times, with officials in the UMass Memorial Health Care systems specifically saying this expansion could severely hurt them by drawing private insurance clients away from Marlborough Hospital.
Beyond the recent HPC report, elected officials including Sen. Jamie Eldridge have noted concerns about the project.
In municipal government, Marlborough and Worcester city officials have raised concerns of their own.
‘It’s egregious’
Select Board member Shelby Marshall said she read both the ICA and HPC analyses.
“There are two very different pictures painted,” Marshall said.
She said the HPC report “spoke all about cost and there was zero about quality.”
Fernandez said she was correct, though he noted that HPC’s charge was to monitor statewide spending and medical expenses.
He also said that there have been capacity problems since before the pandemic.
“It was here before COVID — it’s just worse, way worse now that we’ve had COVID,” Fernandez said.
Chair Allen Edinberg also noted that HPC’s report indicated that they didn’t model commercial revenue loss by other providers, but that it was likely to decrease their revenue.
“So, they’re predicting a decrease in revenue to other providers without actually having modeled it and done the analysis to see if that would actually be the case,” Edinberg said.
Marshall said she made lists of the pros and cons of the project.
“It’s a lopsided seesaw to me on the pros,” Marshall said. “I think this project is good not only for Westborough, but for the communities that we’ve also identified in the catchment area.”
She noted a shortage of care among primary care physicians and specialists.
“This project absolutely addresses unmet needs in our community,” Marshall said. “To see it any other way and to see it as a grab from other hospital systems, it’s egregious.”
Next steps
As of the Select Board meeting, Fernandez said MGB was waiting for a staff report from the state Department of Public Health.
After that is filed, MGB will have to wait 20 business days for parties to comment on the recommendations.
On April 6, MGB plans to go before the Public Health Council for what it hopes will be approval of the project.
RELATED CONTENT
New analysis projects impact of proposed MGB expansion on health care costs
Hospitals respond to Attorney General’s report on proposed MGB expansion
Marlborough Hospital executives talk priorities, concerns in town hall meeting
Westborough Select Board approves payment in lieu of taxes agreement with Mass General Brigham
