Group After Group Outlines Destabilizing Effects of Mandated Ratios

In its report on the excessive costs that Question 1 would impose on the Massachusetts healthcare system, the Health Policy Commission (HPC) noted that “a majority of stakeholders identified proposed mandatory nurse staffing ratios as a top area of concern.”

The stakeholder comments came from pre-filed testimony that had been sent in recent weeks in preparation for HPC’s October 16-17 annual cost trend hearing. The HPC will address mandated nurse staffing ratios at that hearing and will include a panel discussion on the topic. The HPC annually sets a statewide target for total healthcare spending. That target is 3.1%, which many feel cannot be met with the imposition of nearly a $1 billion in new annual costs as a result of government-mandated staffing ratios.

More than two dozen hospital, insurers, or physician practices included in their testimony fervent pleas against ratios. Some examples follow:

Atrius Health said as hospitals would be forced to hire more nurses there would be “attendant increases in costs of care and difficulty for Atrius Health in recruiting nurses to support ambulatory and home-based care.”

Baystate Health decried Question 1’s “astronomical and unfunded price tag, no promise of improved care, lack of scientific data to support the proposed law’s arbitrary staffing levels, loss of bedside control for nursing staff, and a downstream of other unintended negative consequences.”

Cape Cod Health said its financial hit from Question 1 would drive its cost growth north of the state’s 3.1% cost growth benchmark. To meet that benchmark, “service lines which are already vulnerable, such as infectious disease, behavioral health, and obstetric clinics will be at risk of survival.”

Holyoke Medical Center envisions “closure of essential services” if the ballot question passes, and Mercy Medical Center/Providence Behavioral Health Hospital said the costs associated with Question 1 “will have a particularly destabilizing impact” on behavioral health.

Reliant Medical Group wrote that “the increasing labor market competition and escalating salaries for nurses could significantly hamper our efforts to manage total medical expense by engaging in comprehensive care management and population health activities.”

And Southcoast Health stated strongly that “Public healthcare policy must be made by trained, experienced healthcare professionals at the bedside and not initiated by special interest groups that garner enough signatures. If passed, the Nurse Staffing Ratio will create onerous and unnecessary operational challenges and ill-advised internal restructuring that will lead to a loss of critical healthcare services.”