Department of Public Health regulators unveiled their recommendations regarding Mass General Brigham’s expansion proposal that involves five sites and facilities across Greater Boston. The hospital system filed three distinct “determination of need” requests with the regulators for their review and approval. The regulators approved—with changes—two applications calling for major rebuilds of Massachusetts General Hospital and Faulkner Hospital (owned by Brigham & Women’s Hospital).

If DPH’s Public Health Council approves the staff recommendations, the Massachusetts General Hospital project can proceed, though without the requested 94 new beds. At Faulkner, all requested new beds and new technology were recommended for approval, but DPH staff proposed ongoing monitoring so that new Faulkner beds will not help the mothership, Brigham & Women’s, gain more higher-priced patient admissions.

Most important, DPH staff told Mass General Brigham leaders of their recommendation to disapprove expansions and new outpatient facilities in three affluent suburban communities: Westwood, Westborough, and Woburn. Not wanting to get an official denial, Mass General Brigham officials withdrew that application entirely last week. By so doing, they could refile the expansion requests separately or in combination.

With this move, DPH now joins its sister state agencies (the attorney general’s office, the Massachusetts Health Policy Commission, and the Center for Health Information and Analysis) in committing to guard the integrity of the state’s health care cost growth benchmark, the hallmark feature of the landmark 2012 Massachusetts cost control law. DPH regulators recognized the Health Policy Commission’s judgment about cost growth concerns from the expansions if approved.

With an extravagant advertising campaign in the New York Times, the Boston Globe, TV stations, and elsewhere, Mass General Brigham made a major bid at outflanking its suburban healthcare rivals. UMass Memorial in Worcester, in particular, went public, with CEO Eric Dickson becoming the public face of opposition and charging that the proposed expansion would rob his facility of higher paying commercially insured patients. The Massachusetts Association of Health Plans took a strong public stand against Mass General Brigham’s ambitions, as did the state’s consumer advocates at Health Care for All.

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