Is Boston Children's $1B expansion actually needed? 4 thoughts

Boston Children's Hospital's $1 billion expansion plan has been met with resistance by many patients' families, as the construction would require building over the cherished Prouty Garden, a place of respite for many sick children. But the controversy surrounding the expansion plan goes even deeper, with many critics questioning whether the expansion aligns with the state's goals to cut healthcare spending, according to The Boston Globe.

The children's hospital, which houses 404 inpatient beds and numerous outpatient facilities, plans to add 71 beds to its Longwood campus and an eight-story outpatient center in Brookline, Mass. The $1 billion proposal is the biggest capital project to seek approval from the Department of Public Health, according to The Boston Globe.

However, some healthcare industry experts and executives at competing hospitals argue the expansion is unnecessary, and will actually drive higher healthcare spending. Here are four takeaways from the report.

1. Demand for children's hospital care is decreasing. Boston Children's Hospital's own data supports the local and national trend of declining demand for children's hospital care. The decline is mostly attributed to medical advances that reduce the need for overnight hospital stays and a projected dip in Massachusetts' pediatric patient population.

However, Boston Children's executives argue there is enough demand to justify the expansion, especially among patients with complex and chronic conditions who have longer inpatient stays.

2. The hospital may see less medical tourism than expected. Public health officials required Children's to pay for an independent analysis to examine the cost implications of the expansion project. The report, by Navigant Consulting, said Children's will see a rise in the number of patients visiting from around the nation and the world. However, critics contend many countries that currently send patients to the U.S. for treatment are improving their own healthcare systems and may send fewer patients over in the future.

3. Competitors say the expansion will limit patients' options. The proposed expansion at Boston Children's could add to its already dominant market power and contribute to increased healthcare spending, some executives of competing hospitals say.

"If the marketplace becomes monopolized by one institution, then we and the other providers of tertiary care for kids won't have a sustainable model to maintain these services," said Ronald E. Kleinman, MD, physician-in-chief at MassGeneral Hospital for Children, according to the report. "We'll then have a situation where there is only one player in town and it provides the most expensive care possible."

4. Children's says the expansion won't heighten competition with other local children's hospitals. Sandra L. Fenwick, CEO of Children's, said the new clinical spaces wouldn't position the hospital to fight with competitors to fill beds, as Children's sometimes has to turn patients away due to lack of space, according to the report. She also said, "Patients are finding their way here because we are offering treatments that others do not," according to the report.

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