Hospitals across Massachusetts, including Mass General Brigham, are facing overwhelming capacity issues, and COVID-19 is only a part of the problem. Deferred care for serious illness, chronic health problems, and a mental health crisis have brought a flood of patients to our hospitals and health centers.
Newspaper headlines across the state tell the story:
“Hospital capacity stretched more than it has ever been”; “Hospitals postponing thousands of surgeries amid onslaught of COVID and other patients”; and “Unsustainable: Boston hospitals could face disaster.”
Massachusetts hospitals find ourselves caught in a perfect storm of staffing shortages, sick patients due to delayed care, and the repeated resurgence of COVID-19, affecting both patients and caregivers. Some hospital leaders have warned of the need to ration care. The Massachusetts Department of Public Health has called the hospital staffing shortage “critical” and ordered hospitals to postpone surgeries and medical procedures for tens of thousands of patients. Tufts Medical Center announced last week that it will create new adult ICU capacity by closing its children’s hospital in July.
It is clear hospitals need long-term solutions to increase capacity for patients, now more than ever. In fact, Mass General Brigham sought to address this growing problem before the onset of COVID-19. We developed a plan to increase capacity for patients by modernizing Massachusetts General Hospital and adding community beds to Brigham and Women’s Faulkner Hospital. In addition, Mass General Brigham has proposed to expand care at our Westwood health care center, and open new ambulatory care centers in Westborough and Woburn to serve our existing 227,000 patients in a less expensive setting, closer to where they live.
Given the severity of the capacity crisis — especially for the sickest patients and most complicated cases — one might assume that an effort to expand access to care would be embraced, perhaps even celebrated by health care providers around the state. Unfortunately, in the world of Massachusetts health care politics, that is not the case. The loudest opponent to the Mass General Brigham expansion is the Coalition to Protect Community Care, whose leading members include the for-profit Shields Health Care Group, and the large health care system UMass Memorial Health, which is currently facing the same capacity crisis at its hospital.
Now, the state’s Health Policy Commission has chosen to ignore this crippling capacity crisis and the patients affected by it, instead issuing a report that condemns the Mass General Brigham expansion plan based on cherry-picked data, unsubstantiated projections, and supposition. The HPC disputes a state-commissioned independent cost analysis that found the Mass General Brigham expansion would increase primary care, behavioral health, and specialty care such as cardiology and orthopedics, to more patients while reducing costs. That analysis shows patients who move their care from Mass General Brigham hospitals to the new suburban care centers will save as much as 35 percent on everything from imaging to outpatient surgery. That plan will not only save money for our 227,000 patients when they use the ambulatory care centers, it will also create more room in our Boston hospitals.
The fact is, Mass General Brigham treats the sickest patients, many of whom are transferred from other Massachusetts hospitals, and we invest in the technology, research, and innovation that helps us to save their lives, when others are unable to do so. At the same time, publicly available information shows that, after Boston Medical Center, Mass General Brigham spends a higher percentage of total revenue to subsidize the cost of care for Medicaid and uninsured patients than any of its academic health system competitors.
Eventually — hopefully soon — COVID-19 will become a manageable part of our overall health care landscape. But make no mistake: How we care for patients has forever changed. With an aging population, longer lifespans, more complex inpatient and outpatient therapies, and more sick patients due to delayed care, hospitals will continue to be overwhelmed — unless hospitals, elected officials, and regulators act now. Massachusetts must address the patient care crisis by expanding access to care and reducing health care costs. This plan is a good start and one everyone should support.
John Fernandez is president of Mass Eye and Ear, a member hospital of Mass General Brigham and a teaching hospital of Harvard Medical School, and president of Mass General Brigham Integrated Care.