Now the moment of truth Concerns are growing over health care in Massachusetts. In the next week, the state Legislature is expected to decide whether to approve a new health care law, and a federal bankruptcy court in Texas is expected to approve the final sale of Steward Healthcare of Massachusetts hospitals and announce the latest bidder for the hospital system’s physician group.
Here are my hopes for this week:
As for the two Massachusetts hospitals Steward said he will close – Kearney Hospital in Dorchester and Nashoba Valley Hospital in Ayer – he hopes they will be put to multiple uses to serve the needs of the community, both medical and social.
Over the past few months, it has become clear that neither Kearney nor Nashoba Valley Hospital is on track to attract new owners who would keep them as general acute care hospitals. Both hospitals have seen their surgical-medical patient volumes decline for some time, but they also remain important inpatient behavioral health providers. Both hospitals admit geriatric psychiatric patients, and Kearney also has adult and adolescent inpatient units.
I expect the state will do everything in its power to find the best partner to maintain and even expand these inpatient services along with robust outpatient behavioral health services. Freestanding urgent care (and perhaps ambulance services) with behavioral health professionals embedded in the clinical services should be located at both locations. The state may need to step in and work out a reasonable lease agreement with the hospital’s real estate owners, Medical Properties Trust and Macquarie Asset Management, to make this happen.
The state should focus on transforming closed hospital sites into community centers that provide not only health care but also housing, education and job training. “Healthy Village” It is worth considering, and state governments should help facilitate this transformation effort.
My hope is that a Texas bankruptcy court will approve a local nonprofit as the buyer for the remainder of Steward Hospital. Potential buyers include Lawrence General Hospital, Southcoast Health, Boston Medical Center, and maybe even Rhode Island’s Lifespan, soon to be Brown University Health.
Those buyers may need state assistance, such as amending lease terms to hospital owners and providing assistance with capital and operating costs for a period of time. The state has already committed $30 million to help the hospitals continue operating through the end of August, and more spending is likely to be needed.
Steward originally planned to sell the physician group to a for-profit company, Optum, but that deal has now been called off. Getting this important asset out of the hands of a for-profit company is a very good thing, and I hope that whoever the ultimate buyer is, the Health Policy Commission and Attorney General Andrea Campbell will use their influence to ensure that the new owners run the physician group in a way that serves the health care needs of the community, not simply maximize profits.
I commend both houses of the Legislature for their hard work in crafting bills that include similar or similar language that would require greater transparency in hospital finances, require special oversight of hospital owners by private investment firms, and give additional regulatory powers to the Health Policy Commission and the Attorney General.
Both bills also present the idea of bringing drug manufacturers and pharmacy benefit managers (PBMs) under some kind of system to increase transparency and accountability in their pricing activities and actions.
In all of these areas, the House and Senate approaches are not identical, but I feel we could reach an agreement this week.
What I am more concerned about is what actual differences there are between the two bills on the makeup of the board of directors for the Health Care Policy Committee, how to provide affordability support to increase revenue for hospitals receiving lower private payments, and how best to evolve the current one-year health care cost benchmarking into a multi-year study.
Without question, I believe the Senate approach is currently far superior in all of these areas. Rather than go into detail here, I would instead In a letter It was sent to the chairman of the state Assembly’s health care committee by a coalition of employers, insurance plans, health, consumer and social justice advocates, urging concrete action.
It is clear that legislative counsel must craft a final bill that ensures state government has all the best policies and tools, that the right people and agencies are providing oversight, and that our health care system continues to move in the direction of affordability.
Paul A. Hattis is a senior fellow at the Lown Institute in Needham.
