House Speaker Ron Mariano’s bill aimed at protecting community hospitals like East Boston Neighborhood Health Center (EBNHC) that was supported by Rep. Adrian Madaro passed in the House by a 158-1 vote. The bill is now in the Senate.
The legislation, said Madaro, would put more eyes on major hospitals and health care providers that have been expanding into areas already served by community health centers like EBNHC The bill would give the Health Policy Commission (HPC) the authority to investigate the market impact of major hospital expansions that require an additional license if they plan to establish new satellite campuses in places like Eastie, Revere, Chelsea, and Winthrop–communities already served by EBNHC.
The problem, explained Madaro, is healthcare providers like Massachusetts General Brigham have been rapidly expanding into low-income communities as well as suburban locations. This pits larger healthcare providers against smaller providers like EBNHC as they compete for privately insured patients. These patients command higher rates, leaving hospitals like EBNHC with a greater share of patients on Medicare and Medicaid. Studies have shown that when a larger provider moves into an area already serviced by community hospitals like EBNHC they receive significantly higher rates of reimbursement for their services than the community hospital–in some cases more than 30 percent.
Community hospitals like EBNHC already operate on very thin margins with the constant possibility of closure. Madaro said the bill passed by the House would limit unchecked growth of hospital chains, better suiting community hospitals to survive and ensuring continued competition in the health care market.
“Our community providers are the backbone of our local healthcare system, ensuring affordable and accessible healthcare to those who need it most,” said Madaro. “This legislation protects local providers, like East Boston Neighborhood Health Center, guaranteeing that residents across our community can continue to access low-cost, quality healthcare services”.
The legislation creates a more rigorous review to ensure that when large hospital systems expand, they are not infringing on community hospital markets and raising health care costs for patients. It also requires the ongoing upkeep of a health resource inventory, which willgive regulators a better understanding of the Commonwealth’s existing health care resources to inform these review processes and future reform efforts.
A key highlight of the bill would protect EBNHC’s market and gives the Health Center another tool to halt Determination of Need (DoN) proceedings should a proposed larger healthcare provider encroach on their primary service area. Under the bill the Department of Public Health will determine the need for the expansion of a larger healthcare provider into an area already served by a smaller community health center. Part of the expansion application would require the larger healthcare provider to include a letter of support from the CEO or board chair of an existing independent community hospital like EBNHC if the two entities are providing service in the same area.
“The House took a major step in working to guarantee that every Massachusetts resident has access to quality, affordable health care by passing legislation that will protect community hospitals,” said Speaker Mariano (D-Quincy). “Community hospitals offer high-quality care to the most vulnerable patient populations at affordable rates. Our efforts to control health care cost growth depends on their continued existence.”