Mass General Brigham ads touting expansion are ruffling feathers

The corporate offices of Massachusetts General Brigham hospitals in Assembly Square in Somerville.Lane Turner/Globe Staff

The state’s largest health system wants to expand, and it wants your support.

For weeks, Mass General Brigham has splashed its teal ads across newspaper pages, television screens, and the Internet to rally support behind its proposed $2.3 billion expansion.

The campaign, which experts estimate cost millions of dollars, has angered competitors and a legislator, who say the health system is using its deep pockets to relay misleading information to regulators and the general public. Mass General Brigham, for its part, says it’s using the ads to dispel misinformation spread by critics and to speak directly to patients.

“It is important people know the facts, and advertising is just one way to make sure those facts are publicly known and set the record straight from unfounded claims,” said Jennifer Street, a spokesperson for MGB.

The hospital’s competitors say MGB, already the largest and most expensive hospital in the state, is using its vast resources to grab more power.

“It is often the case that whoever has the most cash can buy market share,” said Dr. Eric Dickson, president and CEO of UMass Memorial Health, which has hospitals in the service area where MGB is seeking to expand. “That’s true in any industry, especially when the competition is kind of fighting for survival. That’s when you can use your cash for a knockout blow. That’s what it feels like here.”

MGB has been trying for months to secure state approvals for its expansion, which includes opening or growing ambulatory sites in Westborough, Westwood, and Woburn, and expanding Massachusetts General Hospital and Brigham and Women’s Faulkner Hospital in Jamaica Plain.

The projects, especially the planned outpatient sites, have come under fire from competitors, consumer advocates, and the attorney general over concerns that the new clinics would draw patients away from lower-cost facilities and ultimately siphon much-needed revenue from community hospitals. The state’s health care watchdog agency and Attorney General Maura Healey have questioned the plans, saying they would raise annual health care spending by $46 million to $90.1 million by drawing patients to higher-cost facilities and creating a new referral pathway to the system’s downtown hospitals.

At the same time as the system faces pushback for its expansion plans, legislators on Beacon Hill have been at work trying to pass laws that would tighten oversight of hospital expansions, making it even more difficult for large systems like MGB to grow.

Now, MGB is fighting back. In its ads and in letters to regulators, it argues that its expansion would help lower costs by moving patients out of its Boston hospitals into less expensive suburban outpatient centers and make space downtown to deal with existing capacity issues. Executives have pointed to an independent cost analysis that MGB commissioned, a requirement as part of the state regulatory process, that also said the expansion likely wouldn’t raise health care spending.

Over the last three months, MGB has taken out more than a dozen full- and double-page ads in the Globe, the Boston Business Journal, and the Worcester Telegram & Gazette, accompanied by digital ads in the Globe and BBJ.

Additionally, cable news stations have broadcast commercials during morning, evening, and weekend programming.

The ads prompt viewers to visit a website that makes its case for expansion and asks users to sign a petition in favor of its projects, sign up to appear in a future commercial, or invite experts from the health system to speak at an event.

Street, the MGB spokesperson, declined to specify how much the system was spending on the campaign, but said the ads around expansion are part of the system’s broader rebranding campaign launched in 2020.

“The development of two new health care centers in Westborough and Woburn and the expansion of our health care center in Westwood is an important part of the integrated system,” Street said. “It is important for our patients living in these communities to be aware of what we are doing to improve their access to care, lower their health care costs, and address the critical need for capacity at our hospitals.”

Experts say the ads likely range between $1 million to $7 million, and are helping build a foundation of support the system will need if it enters a regulatory fight.

“They want to expand their brand awareness and reach more patients and expand their patient base,” said Carolyn Morgan, president of health care marketing and advertising firm PRECISIONeffect. “I get why other hospitals in those areas are concerned. They should be.”

Expert estimates of the spending on the campaign are in line with the health system’s previous marketing budgets. According to a search of records with media research company Neilson Ad Intel, MGB spent approximately $3 million in media buys last year. But those figures are likely low, because the service doesn’t count the full extent of digital ad campaigns, misses many local TV news station buys, and doesn’t include any paid search campaigns or the cost of hiring ad agencies to produce marketing content.

Niyum Gandhi, chief financial officer and treasurer of MGB, said the system hadn’t increased its media budget year-over-year but has just consolidated marketing budgets from across its network into one place.

MGB’s competitors say the ads are deceptive.

“They are not being honest with the people of Massachusetts,” said Dickson of UMass Memorial. “It is very clear from to anyone who looks at this, who hasn’t been hired by MGB, that this will drive up costs.”

Several experts echoed the critiques. David Rosenbloom, a public health professor at the Boston University School of Public Health, said it was “nonsense” that MGB’s expansion wouldn’t increase spending. Even if the system diverts its own patients from downtown to less-expensive suburban sites, the hospital was expanding its downtown presence and would backfill those beds, Rosenbloom said.

“Miracles happen. There will be a first time when spending doesn’t go up from an expansion like this. This isn’t going to be one of them,” Rosenbloom said.

Leemore Dafny, a health care economist and a professor at Harvard Business School, said MGB’s goal is to grow revenue and attract more patients. That will likely raise spending.

“I understand why they would do that — waging a public relations war trying to create uncertainty,” Dafny said. “But, frankly, on the face of it, it also makes sense that their investment is one designed to increase patient volume. And no one questions if they are more expensive.”

Alan Sager, a professor of health policy and management at Boston University School of Public Health, directly refuted many of MGB’s statements, in particular claims that the system was expanding primarily to care for its current patients.

Maddie Clair, spokesperson for the Coalition to Protect Community Care, formed by competitors and some community groups to protest MGB’s expansion, criticized the use of advertising for expansion while the system as a whole is being audited for its spending. The state’s health care watchdog agency last month placed MGB on a “performance improvement plan,” that will require the system to rein in spending after years of what they say has been excessive growth.

State Senator Cindy Friedman also questioned the spending priorities of an ad campaign around expansion. She herself had heard of several doctors leaving MGB because of burnout and said the system should be spending to support its workforce. She added that MGB was turning what should be a fact-based regulatory decision into a popularity contest.

“What the state’s job is is to ensure that health care remain accessible and available to people and also we’ve got to deal with the cost of it,” Friedman said. “That’s what the regulatory process and the regulatory decision needs to be based on. Not whether we like something or not. That’s why I find it unsettling.”

Street, the system’s spokesperson, said the hospital’s advertising campaign had little to do with how it invested in its workforce, noting that the system’s largest investment was its people.

“Advertising allows us to tell the story of their incredible work, as well as why we need to create more space for them to care for patients,” Street said. “Our commitment to telling that story has no effect on how we compensate employees.”