Keeping The Big Hospitals In Check
Reg. change could slow Boston hospitals from moving west
But a proposed state regulatory change could help the smaller medical centers prevent the big guys from moving into their turf.
Take If Needed
A new state Department of Public Health proposal would make any hospital looking to set up a facility with beds in a new location go through a "determination of need" review. Paul Dryer, director of health care safety and quality at the DPH, said the proposal is a response to recent expansions by teaching hospitals into the Boston suburbs. The satellites may duplicate services that are already available at local hospitals and drive up the cost of health care by charging higher prices, he said.
Andrei Soran, CEO of Framingham-based MetroWest Medical Center, said the proposed regulatory change would be good for community hospitals like his. Although he does not know of any teaching hospital planning to expand into MetroWest, he said he wouldn't be surprised.
"I know that historically most Boston hospitals have looked at the MetroWest area as attractive from the standpoint of demographics," he said.
Soran said facilities operated by big-name hospitals are a threat to community hospitals not because they provide better care but because of their branding. Patients may head to a more expensive, high profile medical center even if their local community hospital can do the job just as well.
In part, Soran said, that's because of the way insurance companies have structured bill payments: A patient may not end up paying any more for a night at a fancy teaching hospital than for one at a less pricey community hospital.
The Cost Of Health
Dr. Dale Magee, president of the Massachusetts Medical Society and a Shrewsbury gynecologist, said higher health care costs are a serious problem for the state. Although the society has not yet issued a formal statement on the DPH proposal, Magee said he believes the heavy use of academic medical centers contributes heavily to Massachusetts health care costs that are 25 to 30 percent higher than the national average.
That's a big problem for the state's drive for universal health insurance.
"If we're serious about getting everybody insured, we have to be serious about cutting the costs of health care in this state," he said.
Dryer and other advocates for the regulatory change point mainly to expansions close to Boston, like a Children's Hospital satellite in Waltham. Soran said he doesn't think many Boston metro hospitals would want to set up shop much farther west than I-495 because of the logistical difficulty of running a facility that far from their headquarters.
As for the big guy in Central Massachusetts, Worcester-based UMass Memorial Health Care has no immediate plans to open new facilities, according to spokeswoman Alison Duffy. She said the hospital doesn't have any particular concerns about the DPH proposal.
The next step for the regulatory change is a hearing scheduled for May 20 in Boston. Meanwhile, the state Senate recently passed a medical cost-cutting bill that would, among other things, expand the determination of need process to include outpatient capital expenditures over $25 million. Neither current state laws nor the DPH proposal apply to outpatient facilities. The bill is now waiting for consideration by the House of Representatives.
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