Clinical Services, Operations & Community Impact at the Mass General Brigham Integrated Care Sites
Every site will provide primary care, behavioral and mental health care and specialty care such as orthopedics, cardiology as well as Day Surgery, Imaging and other services such physical therapy, blood draw station and cardiac testing. Please see the specific health care site page for more information.
Clinics will be open five days a week at the outset with a plan to then expand hours and days based on demand. In addition, Day Surgery operating rooms will be open five days a week and Imaging (MRI, CT, etc.) services will be open six days a week, eight to ten hours a day to provide evening appointments.
When fully operational, we estimate there will be a range of anywhere between 250-700 patients per weekday depending on the facility.
Each site will create an estimated 200 permanent jobs to the community. The development of each site will also generate approximately 300 union construction jobs.
The Mass General Brigham Safe Care Commitment is in effect at all locations across the system to provide the safest possible environment for our patients, visitors and staff.
Overall, the new health care sites will reduce traffic as current patients will be receiving care closer to home rather than driving into Boston. There will be limited impact to local traffic at health care sites as the bulk of appointments will take place during the day rather than peak rush hour.
No. This is a health care center so there are no emergency rooms, no beds, and no ambulances.
Economic Impact of the Mass General Brigham Sites
No. Mass General Brigham has 227,000 current patients residing in communities these health care centers will service and they will benefit from more accessible health care closer to their home. The Determination of Need process requires evidence that the facilities will benefit existing patients and the research confirmed it.
Ambulatory sites, like our proposed health care centers, is less expensive than care received in a hospital because it has fewer fixed costs. Ambulatory sites do not have 24/7 emergency departments, intensive care units, in-patient beds, etc. and therefore result in lower costs for patients.
The COVID-19 pandemic reinforced the importance of increased access to community-based care where our patients live. We strongly believe that we can improve access to high quality health care and lower costs by making these investments.
How is Mass General Brigham able to make investments in expansion projects if it is financially strained by the COVID-19 pandemic?
Increasing access to care for our patients through health care centers have been part of the Mass General Brigham strategic plan for several years. They are long-term expenditures which will borrow funds over many years beginning about six months after approval based on the regulatory timetable.
Will Mass General Brigham pay local property taxes or make payments in lieu of taxes like other nonprofits?
We are a non-profit and tax-exempt organization. However, we always support the community we serve that meets the needs of the community.
We are focused on providing more access to care for our existing 227,000 patients in the three proposed locations.
Mass General Brigham’s Commitment to Communities
Yes. The Department of Need program requires that Mass General Brigham invest 5% of its maximum capital expenditure associated with the project in community health initiatives. MGB also invests in every community it serves.
Yes. Mass General Brigham has a long track record of collaboration with local organizations for specific community health needs and will continue these collaborations in the communities of the new Mass General Brigham health care sites. Our past partnerships included collaborative programs such as flu clinics, mentoring programs, lecture series, as well as online services and virtual physician visits.
No. Mass General Brigham’s goal is to provide our existing 227,000 patients with the right care, in the right place, at the right time. Community-based health resources will increase because of our commitment, as the Determination of Need process allows for significant funding of community health initiatives to support evidence-based strategies that meet the Department of Public Health criteria and health priorities.
Determination of Need (DoN) Program
The Determination of Need (DoN) is a program administered by the Massachusetts Department of Public Health. The purpose and objective of the DoN program is to encourage competition with a public health focus; to promote population health; to support the development of innovative health delivery methods and population health strategies within the health care delivery system; and to ensure that resources will be made reasonably and equitably available to every person within the Commonwealth at the lowest reasonable aggregate cost. In this way the Department hopes to advance the Commonwealth’s goals for cost containment, improved public health outcomes, and delivery system transformation.
The DoN program requires that health care facilities, such as hospitals and other facilities that provide direct clinical care, complete an application for approval by the DoN program if the center is planning new capital improvement projects such as new construction and purchases of certain medical technology. State regulations require a DoN application if a center is planning a Substantial Capital Expenditure, a Substantial Change in Services and Original Licensure, or a Transfer of Ownership or Change in Site. More information regarding the DoN program can be found at M.G.L. c 111, § 25B, under Massachusetts law M.G.L. c. 111, §§ 25C and 51.
DoN applications are reviewed and considered for approval by the Massachusetts Public Health Council (PHC). The PHC is Chaired by the Commissioner of Department of Public Health and comprised of 15 members, of whom 12 are appointed by the Governor and two appointed by the Secretary of Elder Affairs and the Secretary of Veterans Affairs.
If a DoN application is approved by the Public Health Council, the applicant is required to contribute not more than 5% of the project’s proposed expenses in accordance with DPH’s Community-based Health Initiative (CHI) guidelines. CHI plans are required to fund projects which address one or more of the health priorities defined by Department of Public Health. CHI contributions can be allocated to either the CHI Statewide Initiative or to support evidence-informed strategies that meet Department of Public Health criteria in Massachusetts communities. The Department of Public Health requirements regulate how these funds are distributed and monitored.
DoN applications are submitted to the Department of Public Health. Once the application is deemed complete, DoN staff reviews the application for four to six months engaging in a question and answer process with the applicant. After the DoN staff reviews the application, it makes a recommendation to the Public Health Council (PHC) as to whether the application should be approved.
The PHC promulgates rules and regulations, holds public hearings, approves certain appointments, and DoN applications. The PHC consists of the Department of Public Health Commissioner as Chairman and 14 members, of whom 12 are appointed by the Governor. The other two members, who must be non-providers, are appointed by the Secretary of Elder Affairs and the Secretary of Veterans Affairs.
Once DoN staff makes its recommendation, the PHC holds a public hearing regarding the application. This hearing further informs the DoN staff recommendation and includes comments by DoN staff regarding their recommendation, testimony from the applicant, and testimony from any party that opposes the application. Once the DoN application is approved, the applicant is permitted to move forward with the proposed project.