The closure of the maternity ward at Leominster Hospital by UMass Memorial Health has highlighted significant gaps in the authority of Massachusetts health oversight agencies. This decision, announced in September 2023, underscores the need for the Department of Public Health (DPH) to receive enhanced powers from the Legislature to effectively manage the closure of critical medical services.
Currently, the DPH lacks the necessary authority to intervene meaningfully in such closures. The announcement regarding Leominster Hospital’s maternity ward closure came shortly after local lawmakers from Worcester and North Central Massachusetts urged a delay, only to find their appeals ignored. This pattern of neglect reflects the limitations faced by the DPH, which, like the Health Policy Commission (HPC), can only make recommendations without the ability to enforce compliance.
The HPC, an independent state agency tasked with monitoring health care costs, has similarly struggled to implement effective controls. Despite being charged with overseeing cost trends, the HPC’s inability to enforce its guidelines has led to a consistent violation of its cost containment goals. For instance, while the HPC set a cost growth benchmark of 3.6% for 2026, total health care spending surged by 8.6% from 2022 to 2023.
In a competitive market, health care costs do not adhere to the same constraints that other industries face. In the Boston-Worcester-Providence region, compensation costs for private industry workers rose by 3.3% over the past year. In contrast, health care spending appears to rise unchecked, highlighting a troubling discrepancy in cost management.
Despite these challenges, the HPC remains committed to setting a cost-containment target. During a recent meeting, officials urged health care leaders and policymakers to “recommit to the health care cost growth benchmark” for 2026 and to convene discussions aimed at comprehensive reforms. The HPC’s board has reiterated the need for action following a December 11 hearing that focused on affordability challenges and the potential loss of insurance coverage due to federal policy changes.
Critics argue that the cost growth benchmark, originally established in 2012, has proven ineffective in curbing rising health care costs. Jon Hurst, President of the Retailers Association of Massachusetts, noted that the benchmark has not been adhered to for over a decade. The HPC’s latest cost trends report identifies recurring themes that drive health care spending: administrative complexity, high prices, pharmaceutical costs, and avoidable medical visits.
According to Lora Pellegrini, CEO of the Massachusetts Association of Health Plans, the HPC has consistently highlighted these factors, yet they remain unaddressed. She stated, “The affordability challenges we face today are the direct result of a failure to act on what the data has long made clear.”
To tackle these issues, the HPC has called for Massachusetts to significantly reduce administrative complexity in the health care system, prioritizing changes that hinder patient care and burden primary care providers. The recommendations also emphasize the need to control excessive prices for provider services, noting that other states have successfully moderated costs.
As prescription drug spending continues to rise, the HPC advocates for the state to consider recommendations from the newly established Office of Pharmaceutical Policy and Analysis. Additionally, the HPC urges a focus on reducing “low-value care” and avoidable emergency department visits, with an emphasis on expanding access to behavioral health care and primary care services.
Despite the comprehensive roadmap outlined by the HPC, the reliance on recommendations without enforcement mechanisms raises concerns about the effectiveness of proposed reforms. As Pellegrini pointed out, “The time to act is now.” For real change to occur, both the DPH and HPC must be equipped with the authority to enforce their recommendations, ensuring that health care costs can be managed effectively in Massachusetts.
