Boston Business Journal | These were the six biggest Massachusetts health care stories of 2022
By Cassie McGrath
Story Originally Appeared in the Boston Business Journal
The Covid-19 pandemic has permanently changed the Massachusetts health care system, from raising the profile of telehealth to meet a growing behavioral health need, to spurring a workforce shortage that's forced leaders to rethink long-term staffing.
But in 2022, as health care executives continued to grapple with those challenges, other major health news — including the overturning of Roe v. Wade — shocked the system in a different way. Meanwhile, health care leaders also took up initiatives to address long-standing issues, like hospital spending and health care equity.
Workforce shortages
Gov. Charlie Baker has repeatedly called workforce shortages the biggest challenge in health care. The numbers are staggering: a Massachusetts Health and Hospital Association study from July found 19,000 job vacancies in acute care hospitals. That's forced providers to hire more expensive temporary staff or extend their stays in hospitals, putting pressure on finances as well as capacity.
Some patients, frustrated at the longer wait times, have lashed out at hospital staff, raising safety concerns. Mass General Brigham updated its patient code of conduct in response to that behavior, but poor treatment has only made it harder for people who work in hospitals and made them even more likely to leave.
Strategies to address shortages have included salary increases, polls of workers and new training programs at Assumption University and UMass Chan Medical School, but the problem remains complex.
State reins in MGB
Massachusetts' largest private employer, Mass General Brigham, was forced to withdraw its proposal to open three suburban ambulatory care centers in Woburn, Westborough and Westwood on April 1 after learning that Department of Public Health staff would not recommend approval of the expansion.
MGB argued that the centers would help patients receive cheap, high-quality local care. But smaller health care providers and chambers of commerce united against the plan, saying that it would hurt the finances of smaller medical centers.
That wasn't MGB's only run-in with the state this year. In January, the Health Policy Commission issued its first-ever performance improvement plan, after Mass General Brigham exceeded health care spending growth targets by $293 million — twice as much as the next highest provider.
The PIP is the HPC’s best way to enforce its cost growth benchmark, and in May, MGB submitted a plan to cut spending by $70 million. After back and forth with the HPC, in September, the two sides settled on a plan to reduce spending by $128 million.
However, questions remain about the HPC’s authority to hold providers accountable in its mission to make health care more affordable.
Reproductive health
In June, the United States Supreme Court overturned Roe v. Wade. The decision caused an influx of patients to Massachusetts, rallies, and condemnations from Massachusetts leaders, including Mass General Brigham CEO Anne Klibanski, and Gov. Baker who responded by issuing an executive order and signing legislation further protecting reproductive and gender-affirming care.
Nonprofit Reproductive Equity Now released guidance for people seeking emergency contraception without a doctor and Planned Parenthood opened a new center to expand reproductive rights access nationwide.
But while abortion was protected here, access to reproductive care options remained a contentious issue in 2022. This year, Beth Israel Lahey Health closed the North Shore Birth Center, which was a holistic option for low-risk pregnancies in Beverly. There were months of petitions, pausesandprotests to keep the center open, but itultimately closed on Dec. 1.
Efforts to boost health care equity
The pandemic forced a reckoning on health equity issues that have existed for decades, and that work continued into 2022.
In November, the Center for Health Information and Analysis reported that Black and Hispanic people are significantly more likely to rely on the ER. Another study from CareQuest, found that people of color experience disproportional discrimination during oral health care.
To help address those disparities, East Boston Neighborhood Health Center opened a new site in Everett to support the local, aging population who want an alternative to a nursing home.
Point32Health partnered with Cortica to expand access to neurological therapies for children with Autism Spectrum Disorder and Boston Children’s Hospital, Dana-Farber Cancer Institute and BayCoast Bank invested $1 million into a growth capital fund for businesses owned by Black, Latino, and Indigenous entrepreneurs and other people of color.
Growing need for behavioral health services
Another pandemic-caused reckoning is the one in mental health. In fact, an internal survey at Blue Cross Blue Shield found that the need for behavioral health care doubled since the start of the pandemic.
But demand outweighs supply, resulting in a behavioral health boarding crisis. MHA has documented this crisis each week. As of Dec. 5, it said 573 people were staying in hospitals awaiting mental health care. MHA also reported in September that 20% of behavioral health beds were offline because there aren’t enough workers.
In October, Attorney General Maura Healey launched a $2.9M grant program to fight the behavioral health boarding crisis. Boston also named its first behavioral health officer. Boston Medical Center announced plans to open a behavioral health center in Brockton and Tufts Medicine and Acadia Healthcare are building a $65 million behavioral health facility in Malden.
Some companies have launched to fill gaps in care, including InStride Health, which was founded by clinicians at McLean Hospital to expand pediatric mental health access.
Leaders step down, or take on new roles
Some of the most prominent health care leaders also left their roles this year.
Andrew Drefyus, CEO of Blue Cross, will step down from the state’s largest health insurer at the end of this year. Dreyfus held the position for 12 years, and is being succeeded by Sarah Iselin, who will become the first woman to lead the company on Jan. 1.
Stuart Altman stepped down from chair of the Health Policy Commission, a position he's held since it was founded 10 years ago. He left the role July, and was succeeded by retired executive vice president of Beth Israel Lahey Health Deb Devaux.
Secretary of Health and Human Services Marylou Sudders also announced that she is stepping down after eight years in the role. Sudders, who made major strides on Covid-19, behavioral health and Medicaid, will retire on Jan. 5, according to an internal email.
Nationally, the Biden administration selected a Dana-Farber Brigham Cancer Center surgeon and professor at Harvard Medical School as the first woman director of the National Cancer Institute. Dr. Monica Bertagnolli will play a major role in the White House’s “Cancer Moonshot” initiative.