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Bill applies more regulatory control to Massachusetts hospital extensions

BOSTON – The House voted on Wednesday to apply tighter regulatory control to large healthcare providers that have started expanding their operations into markets covered by smaller and financially vulnerable community hospitals.

House Speaker Ronald Mariano described the Hospital Watch Bill as a political companion to the hundreds of millions of dollars in American Rescue Plan Act funds that the legislature is considering investing in hospitals financially. strained during the COVID-19 pandemic.

While Democratic leaders have touted the legislation as a consumer protection measure designed to prevent higher-cost hospitals from luring privately insured patients away from community providers, some of the country’s most prestigious medical institutions State, notably Massachusetts General Hospital and Brigham and Women’s Hospital, strongly opposed the changes.

“We cannot allow hospitals and health systems to simply open in various communities without undergoing scrutiny. Nothing in this bill will prevent the completion of valuable and necessary projects,” said the representative of the ‘State John Lawn, D-Watertown, Speaker of the House. of the health care financing committee. “This bill will help us maintain the world-class health care that patients deserve and expect.

The bill was passed by 158-1, with Rep. Nick Boldyga, R-Southwick casting the only dissenting vote.

The bill would reform the state’s “needs determination” process by giving the Health Policy Commission the power to investigate the costs and market impact of hospital extensions, not just hospital extensions. Mergers and Acquisitions.

Under the bill, providers who apply to the Ministry of Public Health for a license to expand their operations would also have to include a letter of support from the CEO or the chairman of the board of an independent community hospital if the area of ​​?? main service of the proposed expansion project overlaps. with the service area of ​​the pre-existing hospital.

The letter of support would not be necessary if the project is a joint venture.

With the House and Senate embarking on a seven-week break from formal sessions, the bill is not expected to surface in the Senate until January at the earliest. Gov. Charlie Baker has also said he plans to table a health care bill early in the new year.

Mariano previously described the bill as an effort to close a “loophole” in the existing regulatory structure that would give the state greater control over the tendency of vendors like Massachusetts General Brigham to open satellite facilities in areas suburban areas that compete with small community hospitals.

Concern over the expansion of larger providers into new territories is that they will withdraw privately insured patients who order higher rates from community hospitals, leaving these local providers with a larger share of patients. under Medicare and Medicaid.

Kim Hollon, President and CEO of Signature Healthcare-Brockton Hospital, wrote a letter of support for Mariano’s legislation, calling the expansion of wealthy academic medical centers into commercially richer insured markets a “dangerous trend that will increase. the cost of health care in the state and eroding the safety net of hospitals like the Brockton Hospital. “

Hollon said well-funded research hospitals have a greater ability to build capacity, reduce wait times and market affluent commercially insured patients, “siphoning off” patients who reimburse more from community hospitals, despite none. evidence of unmet need in the community.

John Fernandez, president of integrated care for Mass General Brigham, offered a counter-argument by writing a letter to House lawmakers on Tuesday, urging them to reject the president’s bill.

Fernandez warned that legislation could delay and ultimately deny care closer to home to thousands of MGB patients who currently have access to doctors and treatment in Boston.

MGB is looking to expand with new outpatient centers proposed for Woburn and Westborough, and an expansion of its Westwood center. These centers, Fernandez said, will provide primary care, behavioral and mental health care and specialized care such as cardiology, orthopedics, imaging and day surgery at a cost 25% less than that of Massachusetts General Hospital or Brigham and Women’s Hospital.

“Not only do our patients want more care closer to their homes, but given the capacity challenges that every hospital in Massachusetts faces, the state should also increase access to care, not reduce it. Significant increase in emergency and inpatient visits The occupancy and unprecedented demand for procedural and acute mental and behavioral health services are proof that we need better access to health services ” , wrote Fernandez.

Fernandez called Mariano’s bill a “misguided 11th hour intervention” after nine months of regulatory review by the Department of Public Health.

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