In what was cited as the first step in reforming Massachusetts determination-of-need process, the states Public Health Council voted unanimously to approve more stringent hospital-expansion rules.
The new measures will require hospitals to prove a particular community is underserved or lacking services before being allowed to expand into the area. The rules, according to a health department news release, take particular aim at curbing the addition of inpatient beds to satellite facilities without proof of community need. They also will end the use of physician exemption letters, which previously allowed healthcare facilities to avoid needs reviews when setting up new treatment sites such as imaging centers.
These changes will result in a fairer and more deliberate DON process, Public Health Department Commissioner John Auerbach said in a statement.
According to news reports, the move is partially aimed at reducing the expansion of large teaching hospitals such as Bostons Massachusetts General Hospital and Tufts Medical Center into suburban areas already served by smaller community hospitals. Such expansions, according to supporters of the measure, tend to drive up healthcare costs in those regions by offering access to more-costly but not necessarily more-effective healthcare services. State health regulators have said that controlling such expansions will be integral to containing escalating healthcare costs and maintaining the states ability to pay for its year-old state-subsidized health insurance program.
Matthew Fishman, vice president of community health for Partners HealthCare System, Boston, the parent company for teaching hospitals Massachusetts General and Brigham and Womens Hospital, Boston, said he doesnt expect the measure to create tension between teaching and community hospitals. I think what this does is say, these are the rules for adding inpatient beds and you have to follow them regardless of whether youre a teaching or community hospital. -- by Shawn Rhea
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