Today, the Friends of the Prouty Garden (FPG) submitted to the DPH a new report analyzing the Hospital's efforts to create a massive new complex in the Longwood Medical Area of Boston.
The report contends that the proposed $1 billion expansion project at Boston Children’s Hospital (BCH) would further restrict access to quality pediatric services for Massachusetts Medicaid patients and indigent children, while expanding services to wealthy, private-paying international patients.
The report can be read in its entirety here and our press release is below.
New Report Suggests Boston Children’s Hospital’s
Retreat from Caring for Poor
Findings submitted to the Dept. of Public Health detail how BCH’s proposed $1 billion expansion would expand services for wealthy overseas patients, turning its back on local Medicaid recipients
BOSTON – May 12, 2016 –A proposed $1 billion expansion project at Boston Children’s Hospital (BCH) would further restrict access to quality pediatric services for Massachusetts Medicaid patients and indigent children, while expanding services to wealthy, private-paying international patients, according to a new report analyzing BCH’s efforts to create a massive new complex in the Longwood Medical Area of Boston.
The report was compiled by John Lynch, a Massachusetts healthcare consultant, for supporters of Prouty Garden, a group of patient families, physicians, staff and donors who oppose the expansion design proposed by BCH. It was submitted to the Massachusetts Department of Public Health (DPH) today as part of the Department’s ongoing Determination of Need (DoN) review of the Children’s proposal. Members of the Friends of the Prouty Garden are participating in the DPH process as members of an officially intervening taxpayer group. Attorneys for the group today filed with the DPH Lynch’s report and other documents that outline a series of steps the hospital has taken that have restricted access to care at BCH by poor residents of Massachusetts.
The report concludes that the DPH should deny BCH’s DoN application, contending that the hospital is neglecting its fiduciary duty as a Massachusetts non-profit organization by systematically rolling back access to its services by Medicaid patients and other medically indigent children enrolled in Medicaid Managed Care Organizations (MCOs), while at the same time pursuing profitable international patients.
“The Project’s approval as submitted would further distance BCH from its roots in service to the poor in favor of global riches and ambitions that not only defy its history, but render it increasingly inaccessible by the very indigent patient populations for which it was founded and which are the focus of the Determination of Need process,” Lynch wrote.
Lynch’s report points out that Massachusetts’ Medicaid program is quickly moving away from traditional fee-for-service coverage (reflected as Medicaid patients in BCH’s financials) to Medicaid Managed Care Organizations (included with private pay patients in BCH’s financials). Half of the children covered by Medicaid (known as MassHealth in Massachusetts) are now in these managed care organizations (MCOs), with the rest scheduled to be moved into them soon. There are six MCOs in Massachusetts, and all have either terminated or severely curtailed access to BCH because they cannot afford its high rates.
“Approval of BCH’s Application will exacerbate this trend of indirectly (i.e., via Medicaid MCOs) discouraging Medicaid access to BCH’s services because BCH enjoys unique status as the state’s only dedicated children’s hospital,” says the Lynch report.
As follow up to BCH’s December 2015 DoN application, the DPH asked the hospital for information about how its proposed expansion – the most expensive hospital project in state history - would affect access to care at BCH by children covered by MassHealth. BCH submitted a one-sentence answer: “Boston Children’s hospital (sic) does not anticipate any decline in its MassHealth or out-of-state Medicaid payor volume as a result of this Project.”
“This cavalier and superficial response strongly suggests that BCH has not properly considered how this massive expansion would affect care for the poor. The state has no way to evaluate BCH’s demand from outside the United States and is the only party that can force BCH to live up to its obligations as a non-profit hospital and get serious about renewing its commitment to serving poor children right here in Massachusetts,” said Lynch, whose healthcare experience includes serving as President and CEO of Medical Diagnostics, Inc. in Burlington; heading up Lynch Associates, Inc., a strategic consulting practice for doctors and hospitals; and directing DoN project reviews for the regional health planning agency for Greater Boston.
Among other findings, the report states:
• BCH provides 50% less free care than its peer children’s hospitals nationally;
• BCH’s Medicaid patient volume amounts to 33.2% of its patient volume, which is 36 percent below the rate at other US children’s hospitals;
• BCH plays hardball with insurers, locking out medically indigent children formerly on Medicaid but now assigned to MCOs that can’t afford its rates.
In addition, Lynch notes that the hospital has not demonstrated a need for the record-setting expansion, citing data from the state’s Center for Health Information and Analysis (CHIA) showing inpatient volume declined by 17.6% percent since 2010, to a current occupancy rate of about 78 percent. This is less than the state average acute care hospital occupancy rate and does not support Children’s contention that it desperately needs more beds, much less a 12-story building that would double the current size of its Longwood campus.
For more information, contact Jim McManus (jim@sloweymcmanus.com, 617-523-0038 x2) or Lisa Capone (lcapone@sloweymcmanus.com, 617-523-0038 x-4).
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