... But Ratio Ballot Question Threatens Trend

While hospitals, physicians, insurers, state government, and employers stressing wellness programs among their workers are all working to drive down healthcare costs in Massachusetts, one massive, looming, unfunded expense threatens to erase the success to date.  The proposed statewide ballot question to impose one-size-fits-all ratios on hospitals is estimated to cost in excess of $830 million annually.  Last Wednesday, various healthcare interests warned the HPC of the impending budget-busting proposal.

Atrius Health is “deeply concerned” about the ratio ballot question, according to testimony submitted by Steven Strongwater, M.D., president and CEO of Atrius Health, representing more than 900 physicians serving approximately 720,000 patients in the commonwealth. “We do not believe the imposition of staffing ratios will have a material impact on patient safety … These initiatives could have a direct impact on the ability of all providers to meet the established benchmark,” he said.

MHA agreed in testimony delivered by V.P. of Government Advocacy Mike Sroczynski. He said that the ballot initiative proposed by the Massachusetts Nurses Association union, which represents less than 25% of the RNs in the state, “is in direct conflict with the tenets of Chapter 224, as it would significantly raise the cost of healthcare in the state with no existing scientific evidence to show that ratios offer any benefit to patient care.”  He added, “To comply with such a measure, hospitals would be forced to end service lines or other innovative investments and redirect funding to labor costs. Several community hospitals with already-low margins would be forced to close. RNs would be pulled from community health centers, long-term facilities and home care, causing staffing shortages for non-hospital providers that often care for the most at-risk patients in the commonwealth. Ultimately, consumers will also feel the cost of this initiative through higher co-pays and deductibles.”

John Erwin, the executive director of the Conference of Boston Teaching Hospitals, said the unfunded mandate of the ballot question would jeopardize “the viability of those hospitals with already razor thin operating margins. There are no scientific studies that indicate this mandate will improve the quality of care for patients in Massachusetts. Instead, this required spending would crowd out other areas of potential hospital investments aimed at increasing efficiency and improving access and patient safety.”