Dr. Eric Dickson is President and CEO of UMass Memorial Health (UMMH), the largest nonprofit health care system in Central Massachusetts, employing over 17,500 caregivers and generating $4.1 billion in annual revenue. The system includes four hospitals on eight campuses with more than 1,000 licensed beds; 70 office-based community practices; a behavioral health service; six urgent care centers; and an Accountable Care Organization (ACO). updated 9/23/24
1.How has the health care crisis in Massachusetts impacted access to essential services for low-income communities?
Even before the erosion of Steward Healthcare, Massachusetts has been facing an unprecedented healthcare crisis. Rising premiums, staffing shortages and capacity challenges, and financial pressures like inflation have significantly impacted patients’ ability to access essential services. These impacts have been felt most acutely in low-income communities already facing barriers to care.
As health care costs rise, we see low-income and underserved patients delaying or skipping necessary care and having to choose between receiving care and paying for their homes or putting food on the table. Patients also struggle to access primary care services across the state, which makes it difficult for patients to receive the preventative health care services they need to stay out of the hospital.
As a safety-net institution, UMass Memorial Health’s mission is to provide exceptional care to our patients and support the health care needs of all patients and the overall health and well-being of the communities we serve by investing in new programs.
In addition to improving and maintaining access to essential health care services throughout Central Massachusetts, we offer community-based services at no cost to patients through our Community Benefits programs. These programs include vaccination drives, mental health services, mobile medical and dental care, senior services, youth programs, social services partnerships, subsidized and charity care, and more.
2. What measures are being taken by local health systems to address post-acute bed and physician shortages in Central Massachusetts, particularly as Heywood Healthcare faces bankruptcy?
We are in the middle of a health care crisis in Massachusetts. At UMass Memorial Medical Center, our tertiary referral center, it’s not uncommon for us to have close to 100 patients in our emergency department waiting for an inpatient bed. On some days, the backlog feels worse than it was at the height of the COVID-19 pandemic.
Staffing in post-acute settings is one of the root causes. Thousands of positions remain unfilled across the care continuum in Massachusetts, forcing some health care providers to take beds offline that cannot be adequately or safely staffed. Chronic understaffing in settings such as skilled nursing facilities and rehabilitation centers, make it more difficult for us to discharge patients to the appropriate care setting and admit new patients.
At a macro level, one way to improve patient throughput is to initiate “care traffic control” – or better manage how patients are admitted to post-acute care facilities after they have received specialized inpatient care. During the pandemic, the Massachusetts Executive Office of Health and Human Services, in partnership with the Massachusetts Health & Hospital Association, tracked inpatient capacity at different health care facilities throughout the state. I’m a big proponent of resurrecting this model for post-acute care settings. Information about which facilities are full or have capacity could help us better understand where to transfer patients and help prioritize transfers from tertiary care centers that are often the most backlogged.
To help address the staffing crisis, we are focused on employee retention, caregiver satisfaction and recruitment at UMass Memorial. For example, our New Graduate Nurse Residency Program helps ensure that recent graduates are placed in the right position within our system, easing the transition from residency to practice and improving job satisfaction and performance. The Medical Center’s first-year nurse retention rate is well above the national average in large part because of this program. We also continue to invest in workforce development initiatives, like our registered apprenticeship program, that aim to expand our pipeline of talent and ensure that we’re reaching candidates who may be interested in a career in health care.
We are also implementing innovative ways to provide care outside of the hospital by scaling our UMMH Hospital at Home program, which has benefited more than 2,000 patients. Designed to improve health equity and lower costs, the program is one of the largest hospital-at-home programs in the country, serving an average of 15-20 patients per day. Its success has led us to become the first health system in the country to accept post-Cesarean patients to Hospital at Home, increasing recovery and comfort options for postpartum patients after delivering via C-section. I believe this is a monumental step for improving equity and outcomes for postpartum patients, while also allowing our caregivers to address social determinants of health in real time.
3.How are rising health care costs affecting families in Central Massachusetts and what is UMass Memorial Health doing to improve affordability?
Residents across the state and in Central Massachusetts are struggling to afford health care. More than 41 percent of Massachusetts residents in a 2021 Center for Health Information and Analysis poll noted that they had trouble affording care in the 12 months previous.
UMass Memorial Health is a safety-net institution, with a mission and responsibility to serve patients from under-resourced communities. Roughly 70 percent of our patients are either publicly insured or uninsured, meaning that they are disproportionately impacted by rising health care and living costs. It is our job to ensure they have access to the compassionate, world-class care they need and deserve.
Last year, we dedicated $340M to public health initiatives and programs that help improve the health of all residents. We will continue to offer these programs, which are integral to the health and wellbeing of the communities we serve, even though we are not reimbursed for them.
4.How has Steward’s bankruptcy impacted the Massachusetts health care landscape and patients across the state?
Many of the Steward Health Care hospitals and facilities are also safety net institutions that play important roles in serving vulnerable members of our communities. With Steward’s bankruptcy – and now with the closure of two of their hospitals — patients are confused and concerned about the future. Some patients are choosing to receive care at other facilities or delaying their care all together, which is challenging our already fragile ecosystem that is seeing sicker patients every day. To ensure patients can receive the services they need and deserve, healthcare organizations across the state have vowed to do their best to serve impacted communities and support continuity of care while Steward Health Care undergoes its exit from the state.
I also want to acknowledge the Steward caregivers working tirelessly to maintain access to essential health services during this disruptive time. I am continuously impressed by their dedication and passion for helping others, even when there are so many questions left unanswered. With the recent closure of Nashoba Valley Medical Center’s, we at UMass Memorial have pledged to offer job opportunities within our system to Nashoba’s staff and providers.
As we anticipate moving beyond this crisis, patients and caregivers alike will need stability. Our industry can learn a lot from our coordinated response in the early days of COVID-19. Our healthcare system must come together to solve the ongoing capacity challenges, address social determinants of health, support continuity of care, and instill confidence as we move forward.
5.What is new at UMass Memorial Health?
There is a lot going on at UMass Memorial Health. We are developing a new inpatient, acute-care facility at the North Pavilion building on the UMass Memorial Medical Center University Campus. It will offer 72 private medical-surgical beds along with outpatient care offerings. By adding more staffed beds to the healthcare ecosystem, our hope is that we can improve access to the services we provide. The North Pavilion will fuse the best of in-person and virtual care, offering convenience, seamless integration, and a highly personalized patient experience, and will feature state of the art technology and equipment. We anticipate this facility being ready for patients in early 2025 and look forward to sharing more with the community soon.
We’re also focused on ensuring our caregivers have the tools they need to be successful, and our organization has made incredible strides advancing our technological capabilities and efficiencies over the last several years. For example, our commitment to fully integrate Epic’s Electronic Health Record (EHR) system at UMMH has paid off significantly. Just six years after our investment in Epic, we achieved Epic’s Gold Stars Level 10 recognition for our exceptional use of the digital platform software —an honor that we have received two years in a row. We were the only health system in Massachusetts to receive the award in 2023 and one of only a handful of organizations across the nation to earn this distinction twice.
