The Massachusetts Public Health Council approved a pared-down version of Mass General Brigham's $2 billion expansion amid opposition from state watchdogs.
The council on Wednesday green-lit a 482-bed inpatient tower at Massachusetts General Hospital and a 78-bed addition to Brigham and Women's Faulkner Hospital. It denied Mass General Brigham's request for 94 new licensed inpatient beds and a PET/MR scanner at Mass General Hospital.
The expansions, including the 94 net new beds at Mass General Hospital, were expected to increase Massachusetts' healthcare spending for its commercially insured residents by $36.7 million to $62.3 million per year, according to the Massachusetts Health Policy Commission.
The original Mass General Hospital proposal would have increased state healthcare costs by up to $54.4 million a year, the commission found. Removing 94 net new beds would mitigate cost inflation concerns, council staff said during its meeting Wednesday.
Boston-based Mass General Brigham, the largest health system in the state, said that it has been running at full capacity. The Mass General Hospital expansion would allow the vast majority of its inpatient beds to be housed in private rooms and the Faulkner project would help move patients from its higher-cost academic medical center, where it can care for the sickest patients, executives said. They also noted the rapidly aging population and the correlated rising demand for higher-acuity care.
Public Health Council staff agreed with those claims, noting that Mass General Brigham would be held to certain conditions, including providing more than $100 million in community benefit funding and regularly updating staff with utilization and patient acuity data.
"We are pleased the Public Health Council has approved two transformative projects at Massachusetts General Hospital and Brigham and Women's Faulkner Hospital, clearing the way for both hospitals to enter the final planning phase," Dr. Anne Klibanski, CEO of Mass General Brigham, said in a statement.
Mass General Hospital currently has 1,043 inpatient beds—388 of which will be transfered to private rooms in the new tower—while Faulkner has 133. Mass Gen was operating at 92% capacity and the Faulkner hospital was operating at 87% in 2019, the system said.
Councilmembers asked whether Mass General Brigham would be able to staff the additional beds amid the national staffing shortage. They also questioned the need for additional inpatient beds over the long-term, given the transition to home and outpatient care.
"By the time we are ready to recruit staff (to Faulkner hospital) by late 2024 and early 2025, we hope that most of these market pressures on staffing are relieved mostly," David McCready, president of Brigham and Women's Faulkner Hospital, said during the meeting.
Mass General Brigham "constantly has more demand than available beds," he said. The Mass General Hospital project is expected to be completed in five to seven years.
Outside of the inpatient bed expansions, the Mass General Hospital project would also add oncology infusion bays, cardiology operating rooms and imaging equipment. The Faulkner hospital project includes an eight-bed observation unit, imaging equipment and shell space for future expansion. The $150 million Faulkner project would increase costs by up to $7.9 million a year, HPC's analysis shows.
Several city and state public officials supported the projects during the meeting.
"The (Faulkner) project will expand (Mass General Brigham's) ability to provide high-quality healthcare and reduce long wait times for inpatient beds," Chelsea City Manager Thomas Abrosino said.
Mass General Brigham pulled its plans last month to add three new suburban ambulatory sites after the state health department didn't endorse the project. The $223.7 million project would have increased annual healthcare costs by up to $27.9 million a year, the HPC said.
The Mass General Hospital and Faulkner expansions will allow Mass General Brigham to increase its prices, which is the main driver behind the system's disproportionately high annual spending growth, the commission found.
"Mass General Brigham has a spending problem," HPC Chair Dr. Stuart Altman said during the commission's January board meeting. "Continuing in this manner is likely to impact the state's ability to meet its spending benchmark and could do serious harm to the structure of the state's delivery system."
The HPC ordered Mass General Brigham to come up with a plan by May 16 to reduce its costs, which exceeded the commission's spending growth benchmark by $293 million from 2014 to 2019.
