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Children’s Hospital plans to expand in Boston, Waltham

Drawing more patients from afar, hospital plans to add beds

The hospital earned $113 million on operations last year, a 28 percent increase, thanks to a surge in international patients.
Boston Children’s Hospital
The hospital earned $113 million on operations last year, a 28 percent increase, thanks to a surge in international patients.

Boston Children’s Hospital plans to add 48 beds to its outpatient facility in Waltham as it pursues a $1.5 billion expansion and renovation of its Massachusetts facilities to meet growing patient demand.

Adding hospital beds in Waltham, which Children’s has not widely discussed, will give the institution a bigger footprint in a part of the state that is close to major highways and surrounded by wealthy suburbs. The site currently offers day surgery and includes doctors who specialize in 97 fields, from gastroenterology to neurology to sports medicine.

The move is part of broader plan by Children’s to revamp its aging Longwood Medical Area campus in Boston and build an 11-story clinical tower there, scheduled to open by 2021. Children’s will add more than 100 inpatient beds across its system— 66 in Boston and the rest in Waltham. The hospital currently has 396 beds.

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As technology and medical care improve, many services and procedures have moved from inpatient to outpatient settings, no longer requiring patients to spend several nights in the hospital. But Children’s executives say they’re seeing enough new patients to justify the expansion. The hospital, while one of the highest-cost health care providers in Massachusetts, is known as a destination for complex pediatric care, and lately it has seen a rise in patients from different corners of the world.

 Boston Children’s Hospital clinicians simulated a surgical procedure to test floor plans for the facilities in a high-rise the hospital will build in the Longwood Medical Area. The mock-ups being used are made of cardboard.
Pat Greenhouse/Globe Staff
Boston Children’s Hospital clinicians simulated a surgical procedure to test floor plans for the facilities in a high-rise the hospital will build in the Longwood Medical Area. The mock-ups being used are made of cardboard.
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Children’s is seeing “significant growth” in patients from the region, the rest of the United States, and internationally, said Dr. Kevin Churchwell, chief operating officer. “We have programs that others don’t have. We are providing opportunities and care for those families who don’t have it in their area.”

Children’s, the dominant pediatric hospital in Eastern Massachusetts, earned $113 million on operations last year, a 28 percent increase, thanks to a surge in international patients. And this month, the nonprofit hospital completed the acquisition of a large and growing New York-based doctors group, saying that it wants to build a network of pediatric care not just in Massachusetts but throughout the Northeast.

Steven Tringale, a Boston health care consultant, said the expansion plan shows that Children’s patients are increasingly coming from outside of Massachusetts.

“The fact that they’re adding some beds is driven in part by the regionalization in the pediatric market,” Tringale said.

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But some in the industry are questioning the move to add hospital beds.

“Pediatric inpatient capacity, both in the community and the tertiary centers, is really quite sufficient,” said Dr. Ronald E. Kleinman, chief of pediatrics at Massachusetts General Hospital, which has about 100 pediatric beds and competes with Children’s. “I don’t see how this is really necessary.”

Children’s has several clinics outside of its main Boston campus, but Waltham is its largest. It has been in that city for a decade, at the site of the former Waltham Hospital, which closed in 2003. The number of patients visiting the Waltham site has grown 35 percent over the past five years; Children’s expects to see 110,000 patients there this year, or more than 2,000 a week.

“The growth of the campus has allowed us to serve an increasing number of children with increasingly diverse conditions,” spokesman Rob Graham said. “In order to take the next step, we need to be able to offer 24/7 inpatient services.”

Beyond adding beds, the expansion plan calls for doubling the number of operating rooms in Waltham to 12 and increasing mental health services, among other specialties. The work, to be completed by 2019, will not include intensive care beds or an emergency department. Newton-Wellesley Hospital and Mount Auburn Hospital each operate emergency rooms a few miles from Waltham. Newton-Wellesley also has an urgent care center at the Children’s site in Waltham.

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Children’s plans to file paperwork to seek state and local approvals for the Waltham and Boston projects later this year.

Mayor Jeannette A. McCarthy of Waltham welcomed the hospital’s plans.

“I think they’re responding to a need,” McCarthy said. “This would be more intensive for the needs of the children so they won’t have to go into Boston as much.”

Lora M. Pellegrini, chief executive of the Massachusetts Association of Health Plans, which represents health insurance companies, said policy makers should examine how the Children’s expansion plan will shake up the industry and affect consumers.

“It is important that any such expansions do not result in increased costs for consumers and employers or exceed the state’s cost benchmark for health care spending,” Pellegrini said.

It’s unclear how the hospital’s expansion will affect costs for consumers and insurers. Children’s said it currently charges less for surgery and imaging in Waltham than in Boston.

“Boston Children’s remains committed to taking costs out of the system, which is why we continue to focus on efficiencies and building our community of care that helps keep patients local,” Graham said.

At Longwood, Children’s is planning to break ground next year on an 11-story, 500,000-square-foot tower that will house a pediatric heart center, an expanded intensive care unit for newborns, and additional operating rooms and patient rooms. As other hospitals have done, Children’s plans to replace its double patient rooms with singles to give patients and their families more privacy.

The new tower and planned renovations of existing buildings will give Children’s more modern spaces in which to install the latest medical equipment and technology, said Churchwell, the chief operating officer. “We have the opportunity to get our operating rooms up to 21st century standards by doing this,” he said.

There are 1,063 pediatric hospital beds in Massachusetts, a number that has declined about 6 percent over the past decade, according to state figures.

The state’s major pediatric hospitals include Boston Children’s, Floating Hospital for Children at Tufts Medical Center, and MassGeneral Hospital for Children.

Priyanka Dayal McCluskey
can be reached at priyanka.mccluskey@globe.com. Follow her on Twitter @priyanka_dayal.