The state’s largest health care provider, Partners HealthCare, is planning an aggressive new expansion beyond its renowned hospitals, spending $400 million to open four outpatient surgery centers that will compete for patients in Boston’s suburbs.
Partners will construct three new clinics near major highways in Woburn, Westborough, and Salem, N.H. It will also expand an existing site in Westwood. All four facilities will offer primary care, specialty care, mental health care, imaging, and surgery, Partners officials said.
The new centers could appeal to patients who want quicker access to medical care, in communities with less traffic and more parking than downtown Boston.
But the project’s price tag could stir concerns about its impact on health care costs for Massachusetts consumers and employers, as Partners is already the state’s most expensive hospital system. The plan needs approval from the state Department of Public Health.
The outpatient expansion is the latest of several new ventures at Partners. In recent weeks, the nonprofit health system announced a new focus on digital health and a massive rebranding campaign. Combined, Partners plans to spend at least half a billion dollars on these initiatives.
The latest project is expected to create 700 new jobs, including doctors and nurses Partners will recruit to work in its new clinics, which are expected to open in 2022. Other health providers have opened outpatient centers in recent years, but no other Massachusetts hospital system has announced an expansion as large as the one at Partners.
“We just need to make it easier for patients to come get our services — which is part of our overall strategy,” said John Fernandez, president of Partners Ambulatory Care, a new division of Partners.
Fernandez said the new clinics will provide a convenient, lower-cost option for care. Partners expects to be reimbursed less for procedures done in outpatient clinics, compared with hospitals, he said — and the company will not charge the hospital facility fees that patients sometimes encounter at outpatient clinics.
The growth strategy will entrench Partners in areas that already have other health care providers.
“There will be patients in those markets that decide to choose Partners. We think we offer a pretty good service,” said Fernandez, who is also chief executive of the specialty hospital Massachusetts Eye and Ear.
The company has been planning new outpatient clinics for more than a year, as part of a strategic planning process called Partners 2.0. Dr. David Torchiana, the former Partners CEO, put Fernandez in charge of the project in October 2018.
The expansion effort slowed after Torchiana unexpectedly resigned earlier this year, but it eventually continued under Partners’ new chief, Dr. Anne Klibanski.
“We need to meet our patients where they are, and address the changing demands of the marketplace,” she said in a statement.
Klibanski is overseeing the company-wide rebranding at Partners. In 2020, the company name will change to Mass General Brigham, a reflection of its major teaching hospitals, Massachusetts General and Brigham and Women’s.
The new outpatient clinics will bear the Mass General Brigham name.
Partners officials said they will file their plans with state regulators in March. The Health Policy Commission, which monitors health spending in Massachusetts, generally doesn’t review such expansion projects, but the commission could choose to submit any concerns to the public health department.
Over the last several years, more health care services have moved from hospitals to outpatient clinics, thanks in part to medical advances that allow patients to be treated and recover more quickly.
Meanwhile, consumers are demanding more convenient options for health care. And companies such as CVS Health and Walmart are opening their own clinics, introducing new competition for traditional health care providers.
Hospitals must give patients more convenient options for care, said Ken Kaufman, chairman of the Chicago-based consulting firm Kaufman Hall. Otherwise, “they’re likely to lose an awful lot of outpatient market share to competitors that are making the whole outpatient experience much more convenient and much more accessible.”
The trend is playing out in Massachusetts. Partners’ biggest local competitor, Beth Israel Lahey Health, is planning to open a facility in Quincy in the spring, offering primary care, specialty care, urgent care, imaging, and laboratory services.
Last year, UMass Memorial Health Care, Shields Health Care Group, and Reliant Medical Group jointly opened an outpatient surgery center in Shrewsbury.
Partners already runs large outpatient facilities in Danvers, Waltham, and Foxborough.
Its four new clinics, 60,000 square feet each, will offer specialists in fields such as orthopedics, ophthalmology, dermatology, and cardiology. Each clinic will have four operating rooms, equipped for patients who need cataract surgery, knee surgery, hernia repairs, and other common procedures.
Nancy Kane, adjunct professor at Harvard T.H. Chan School of Public Health, said the new clinics will save money only if they replace some of the procedures done at Partners’ big teaching hospitals.
But Partners isn’t planning to cut back on hospital services. In fact, the Partners-owned MGH is planning a more than $1 billion expansion of its Boston campus.
“They’re going to be attracting people who would have gone to cheaper places for their outpatient surgery,” such as independent community hospitals, said Kane, who also sits on the board of UMass Memorial.
Lora Pellegrini, president of the Massachusetts Association of Health Plans, which represents insurers, raised a similar issue.
“It will be important for Partners to demonstrate how this proposal will not increase overall health care spending,” she said in a statement. “In addition, the state must evaluate how these centers will impact existing community-based care, and in particular, community hospitals.”
While Partners isn’t planning any new clinics in low-income urban neighborhoods, the health system said it will spend up to $35 million in the Boston area to reduce health inequities and increase access to behavioral health services.
The Partners network includes a dozen hospitals and thousands of doctors. In 2015, the company abandoned plans to acquire three Massachusetts hospitals because of antitrust concerns and the threat of a lawsuit from Attorney General Maura Healey. It started looking more aggressively at out-of-state expansion.
But a plan to acquire Care New England Health System of Rhode Island stalled earlier this year when Governor Gina Raimondo asked Partners to back down, so Rhode Island’s two major hospital systems could try to negotiate a deal with each other.
Partners has also been trying to take over Exeter Hospital in New Hampshire, but the New Hampshire attorney general objected to that deal in September. Partners subsequently began a public relations campaign to boost local support for the acquisition plan.
Meanwhile, the new outpatient clinics are another way for Partners to grow.
“What they’re doing is saying, ‘We want to expand our market share in Central Massachusetts and New Hampshire,’ ” Kane said.