(This article has been updated with a correction.)
Spiraling healthcare costs and frequent community hospital closures were the norm when Northeast Health System and the Lahey Clinic announced plans in 2011 to merge and form Lahey Health, an integrated health system covering northeastern Massachusetts.
One significant cost driver is the large percentage of hospital care in Massachusetts provided in tertiary academic medical centers, said Dr. Howard Grant, Lahey Health's CEO. In Massachusetts, about 40% of patients receive care in academic medical centers, compared with about 16% nationally. That's due more to the number and concentration of academic centers in the state than to residents' need for more complex care, he said.
Meanwhile, more than half of Massachusetts' hospitals have closed over the past two decades. For those communities, the shuttering of their hospital means loss of jobs, economic damage and less access to affordable healthcare, Grant said. As a result, “we made the decision to do everything we could to reduce costs and make sure high-quality care was being provided in the right setting,” he said.
That meant, whenever possible, routing most patients to his system's community hospitals—Beverly (Mass.) Hospital and Winchester (Mass.) Hospital, which joined Lahey Health in 2014—and reserving the system's tertiary academic medical center, 327-bed Lahey Hospital & Medical Center in Burlington, for the most complex cases, such as cardiac surgery, transplants and traumas. “It's a very select population that needs to be cared for in that kind of setting,” Grant said.
Lahey Health does this by working with its employed physicians to communicate the importance of care in community hospitals and the criteria for care in a teaching hospital. While there's no mandate for non-employed physicians to follow the model, Grant said they have also been very supportive of it.