Buying hospitals is not the focus of Mass General Brigham's growth strategy.
President and CEO Dr. Anne Klibanski, who took the helm in 2019, said acquiring hospitals for the sake of getting bigger does not make financial sense for Mass General Brigham, although many other health systems have taken that route.
Related: Mass General Brigham promotes executives, plans department shifts
The nonprofit system, which operates two academic medical centers -- Massachusetts General Hospital and Brigham and Women's Hospital -- as well as three specialty hospitals and seven community hospitals, has its share of pressing issues.
The Boston-based system is wrapping up an 18-month performance improvement plan to curb excessive spending and shoring up finances after a disastrous fiscal year 2022. It is prepping for a split from longtime partner Dana-Farber Cancer Institute while also battling massive capacity issues that have left the Boston area's healthcare landscape in crisis.
In an interview, Klibanski said Mass General Brigham is employing multiple tactics to ensure patients get the care they need. The interview has been edited for length and clarity.
What do capacity constraints look like at Mass General Brigham?
We have the two [academic medical centers], and they are designed and built to provide the highest-level tertiary and quaternary care. … It's really the sickest patients that community hospitals aren't able to treat. The problem is that a huge percentage of care at both of those academic medical centers is really secondary care. That's not appropriate, [but] there's no place else to put them. We have a robust network of community hospitals, [but] they're full too. The capacity challenges that we face are brutal. You've got capacity at sometimes over 100%. You've got patients stacked in hallways.
It’s a throughput issue. You want to prevent people from coming in through the emergency department. You want to get people out when they're ready to go out. You want a place to put people when they need to go, whether they're at home or whether they're in a post-acute facility.
How do you get patients to the right facilities?
Every year, thousands of patients are trying to get transferred to either Mass General or [Brigham and Women's] for tertiary or quaternary care. I took care of patients up until the pandemic when I took this job, and I was always getting calls. They were always the same. They were like, “I have this patient, and here's what's going on, and here's what we're doing. And they're getting into trouble, and they need to transfer in.” Back then, it was like this is going to be hard because the capacity challenges were always there, but we would figure out a way to do it. What's happening now is there are thousands of these calls a year, and there's no room.
We've worked on what's now the first systemwide MGB transfer center. There's one number to call. We have teams around the system. They look at a dashboard every day, and then they are able to immediately think about where this patient could go. If there's no room to go, sometimes they could try another healthcare system.
Where does hospital-at-home fit into this?
We now have the second-largest home hospital program in the country. We are pushing very hard on expanding that because it is the future of healthcare delivery in the home. It's going to be less expensive. You're not paying for these massive buildings that cost a fortune in upkeep. It has better outcomes.
We have an enormous amount of innovation and invention and company spinouts that come out of our healthcare system pretty much all the time. But there are some really great technology partners that have already developed things that we can use. We don't need to invent it.
Best Buy brings technology into the home, and they teach people how to use it. They have a platform around that. … People say, “Well, how do you think about home hospital?” I think about it as another hospital. We have community hospitals, we have academic hospitals, we have specialty hospitals, [and] here's another hospital. It's totally embedded in operations, so that you can transfer people. It’s connected by the same electronic medical record. This partnership with Best Buy enables us to actually provide that care delivery in the home.
Are you open to M&A opportunities?
We're not in the business of acquiring new hospitals. I think a lot of healthcare systems are realizing that just buying more bricks-and-mortar, building buildings, is not actually sustainable from a financial point of view.
I'm willing to look, and I'm interested in learning. … The concept of, “We're not interested. We don't do that,” just doesn't make sense to me. But I will say that going around and trying to acquire hospitals for the sake of acquiring hospitals and getting bigger, I'm not sure how much sense that makes.
We're a bit of an anomalous system. We are a large healthcare system,with 84,000 employees, but we're almost all in Massachusetts. We're almost all in Boston. A lot of these systems that I hear about or talk to, they're actually smaller than ours, but they're in 30 or 40 states. That's a lot of navigation. We have different challenges.
I am and have always been very interested in partnerships. I like the concept of partnerships, whether it's partnerships for services, whether it's partnerships for innovation, whether it's partnerships in providing care.
