MGB withdraws Westborough expansion plan

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By Dakota Antelman and Laura Hayes

MGB withdraws Westborough expansion plan
A rendering shows the proposed ambulatory care clinic that MGB hoped to build in Westborough. (Photo/Courtesy Mass General Brigham)

WESTBOROUGH – Mass General Brigham (MGB) will not be coming to Westborough. 

Just over a year after it first pitched plans to do so, the health care giant withdrew its bid on Friday to open an ambulatory care clinic in the Westborough Office Park off Route 9.

Billed as a way to better serve patients in Central Massachusetts, the proposal was part of a larger suburban expansion plan that sparked fierce debate throughout the region as critics argued that it would actually decrease the accessibility of health care in area communities.

MGB President and CEO Dr. Anne Klibanski confirmed this decision to withdraw in a statement, explaining that MGB took this step after learning that the state Department of Public Health would not be recommending the ambulatory proposal for approval.

“Mass General Brigham remains dedicated to transforming care delivery so that our patients receive the right care in the right place at a lower cost,” Klibanski said. “We will continue to honor our commitment to provide the best care to the 227,000 patients we currently serve at Mass General Brigham affected by the Department of Public Health’s decision.”

MGB planned Westborough care clinic

The clinic would have offered surgery, primary care, behavioral health, orthopedics, neurology and diagnostic imaging, among other specialty care services at the 1400 West Park Drive site. 

MGB’s expansion plan that would have also added another new clinic in Woburn and expanded an existing facility in Westwood. 

MGB officials initially went before the Westborough Planning Board last spring seeking site approval for the project located on a nearly 10-acre site on West Park Drive.

Their plans called for a three-story medical building totaling 61,630 gross square feet.

The Planning Board unanimously approved the plans during a July 6 meeting. 

Though they eventually had local approval, MGB’s plan still remained under review at the state level through last year and into 2022. 

Mass Eye and Ear President and MGB Integrated Care President John Fernandez made the case for the Westborough site during a hearing last April that was moderated by the Department of Public Health (DPH). 

Fernandez argued that MGB had 42,000 patients within a 20-mile radius of Westborough. He said that costs would be lower at the facility because it would be a clinic, not a hospital setting. 

During the April hearing, Fernandez estimated that the project would also bring 1,000 construction and health care jobs to the three suburban expansion sites, including 300 jobs in Westborough. 

Westborough public officials had voiced support for this, pushing back on some of the criticisms leveled against MGB while touting the local impacts they said the local site would have.

Area residents were split, in the meantime, with many arguing in favor of the expansion and still others opposing it.

Marlborough opposed project

Elsewhere, in nearby Marlborough, prominent officials had long been critical of MGB’s plans.

Among them, UMass Memorial Marlborough Hospital officials had specifically said MGB’s proposal could lead to financial problems for their institution.

“[MGB] has the highest costs in the state,” UMass Memorial Health Care Vice President James Leary told the Marlborough City Council last March. “[That] will drive up costs at Marlborough and UMass Memorial Worcester, which have the lowest costs.” 

During the DPH’s April hearing, some meeting participants said the Westborough facility would exacerbate inequities, separating the “haves” from the “have-nots.” 

Among them, Marlborough Hospital officials contended that many of the proposed services at MGB’s site would mirror what is offered in the area, leading UMass and MGB to compete for patients and workers. 

“It basically amounts to cherry-picking at the expense of poor and underserved populations and communities of color in central Massachusetts,” President and CEO of UMass Memorial Health Care Eric Dickson said at one point.

His arguments were backed by the larger Coalition to Protect Community Care, among other individuals and groups.

MGB secured PILOT agreement

Despite the opposition, the project had been moving forward in recent months.

In September, MGB finalized a community service agreement in lieu of taxes with the Westborough Select Board. 

The agreement, also known as a payment in lieu of taxes (PILOT) agreement, was the first such agreement in Westborough’s history.

It outlined a 20-year plan of payments to the town from MGB which, as a nonprofit, does not need to pay taxes.

Just over $900,000 would be sent to Westborough over those 20 years under the terms of the agreement.

Legislators weigh in

State legislators have shared their thoughts throughout this process, with several noting concerns about MGB’s plans and their impact on health care costs.

Locally, this was a topic of discussion this past week at the Corridor 9/495 Chamber of Commerce’s annual legislative breakfast on Thursday morning.

Speaking at that event, multiple legislators reiterated warnings that MGB might pull private health insurance customers away from UMass Memorial properties. 

That, they said, would leave UMass with a higher proportion of patients on Medicare, which does not offer the same reimbursement rates as private insurance.

Such a shift could severely hurt UMass from a financial perspective, according to legislators.

“Those people who have commercial insurance are exactly the people that this new hospital right in our backyard are seeking to take,” State Sen. Harriette Chandler said. “[MGB] would eat, basically, UMass’s lunch. We cannot afford that.”

Chandler, who recounted the history of the UMass Memorial Health Care system, noted a personal gratitude for its services after she said doctors recently saved her husband’s life.

“It is a wonderful hospital,” she said. “…We are so lucky to have it. And I promise you, if we have Mass General Brigham, you won’t have the same kind of UMass that you currently have.”

State Rep. Hannah Kane emphasized that her concerns about MGB’s expansion did not come from an individual opposition to MGB itself. 

They came, instead, from what Kane described as “overall need to lower the rising cost of health care,” adding that MGB is a “contributing factor” to that rising cost.

“This is a macro issue for us, much more than it is a micro issue,” Kane said of oversight of health care proposals.

Chandler and others also touted UMass’s role as an economic engine in the region, warning about the ripple effects that this MGB expansion could have if it were to weaken UMass. 

“We have these wonderful assets that we should do everything we can to support,” echoed State Rep. David Muradian.  

‘David can beat Goliath’

This project had remained in the DPH’s Determination of Need review process after local negotiations concluded with that Westborough PILOT agreement.

As part of the state’s review, an outside firm finalized an independent cost-analysis for the project that concluded that the expansion would lead to a slight decrease in overall health care costs for services at the proposed clinic. 

MGB had celebrated the results of the ICA even as opponents argued that it was too narrowly focused.

Attorney General Maura Healey released a report on the project, as did the independent Health Policy Commission, which concluded that the expansion was actually likely to shift patients and revenue away from other providers. 

In total, the HPC estimated that MGB’s plans would also translate to a $90.1 million increase in annual state-wide health care spending. 

Regardless, MGB was still on track to move forward as recently as a Feb. 8 Select Board Meeting, where Fernandez presented an update to the board estimating that the Westborough clinic would open in the summer of 2023. 

As of Friday night, the state site tracking the determination of need process showed that that MGB had withdrawn its application.

This news broke less than 48 hours after the Corridor 9 legislative breakfast.

State Sen. Jamie Eldridge, who has loudly opposed the MGB proposal, promptly celebrated on social media.

“This was an impressive organizing campaign including the ‘Boroughs legislative delegation, hospital unions, doctors and nurses, and municipal officials, to defeat MGB trying to bring surgical centers to communities including Westborough, that would have increased healthcare costs, and threaten[ed] care for low-income patients,” he wrote. 

“David can beat Goliath!” he added.

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