Partners HealthCare changed its name to Mass General Brigham — but not its appetite for growth. It just repackaged it.
In recent years, the health care network formerly known as Partners was stopped from acquiring hospitals in Massachusetts, Rhode Island, and New Hampshire. Today, Mass General Brigham wants to build outpatient surgery centers in Westborough, Westwood, and Woburn. With a new name and game plan, will its latest expansion wish be granted?
Health care rivals, community groups, and some lawmakers in the affected locales are lining up against it. Mass General Brigham officials attribute the opposition to self-interest. But there are legitimate public policy concerns. It’s good to have more care on an outpatient basis, but how much of it should cater to the well-insured in reasonably affluent areas? “They (Mass General Brigham) see this as a way to increase their market share in areas where there are insured folks who can pay higher rates,” Speaker of the House Ronald Mariano told me. In the long run, that will “raise the total cost. There’s no way around that,” he said.
Long before he took over leadership of the House, Mariano, of Quincy, challenged a push from what was then Partners to acquire South Shore Hospital in Weymouth, on the grounds that it would drive up costs there. That merger was halted in 2015 when a superior court judge rejected a deal that had been worked out by then-Attorney General Martha Coakley. After that court ruling, Attorney General Maura Healey, who had just taken office, said she would go to court to block the acquisition.
Partners backed off. But now, a rebranded Mass General Brigham has a new growth plan, which is playing out against a shifting political landscape. Besides new House and Senate leadership, the 2022 governor’s race lies ahead. Governor Charlie Baker has not said whether he’s running for reelection; Healey may run. Who will stand up for health care cost containment — and against the powerful interests represented by the state’s largest health care provider?
This plan needs approval from the Public Health Council, an entity that falls within the purview of the state Department of Public Health — an arm of the Baker administration. The DPH is requiring Mass General Brigham to hire an outside expert to analyze the impact on health care costs. Of that arrangement, Mariano said, “That smacks of silliness. There’s no independence.” A state watchdog health agency called the Health Policy Commission can also weigh in with a nonbinding recommendation.
Healey was a big player in the showdown over South Shore Hospital. What about now? Asked for the AG’s view, a spokeswoman noted that new construction does not trigger the same kinds of legal review that a proposed merger would under antitrust laws. “That being said, our office is concerned about developments that could further destabilize safety net providers or present other barriers to access to care and that could increase overall cost of care,” Healey’s spokeswoman said via e-mail.
Mass General Brigham officials insist this project will provide high-quality, cost-effective care. The surgery centers would be licensed as clinics, not hospital facilities; insurers would supposedly pay 25 percent less for services delivered at these sites compared with community hospitals. Yet, according to a recent opinion piece in Market Watch, the providers most to blame for rising medical costs “are local hospital systems that dominate nearly every metro area, from Partners HealthCare (Mass General Brigham) in Boston to Sutter Health in the San Francisco Bay Area. These mega-providers don’t deliver better quality than smaller systems and independent providers; they just get paid more, sometimes twice as much for the same medical procedure.” Try telling that to anyone who believes in the Mass General Brigham brand and has insurance to pay for it.
The market dominance of Mass General Brigham is part of a long-running debate over the future of health care in Massachusetts. “Their strategy makes sense if you just want one provider. That is the ultimate goal,” said Philip Johnston, a former state secretary of health and human services who runs a consulting firm that represents community health centers, among other health care interests.
Mass General Brigham would not put it that way. But that’s one consequence that must be considered if Massachusetts grants them permission to satisfy their hunger to grow.