September 15, 2016
Massachusetts Department of Public Health
250 Washington Street
Boston, Massachusetts02108
Dear Sir/Madame:
I am writing to oppose the proposed changes to the regulations governing how Determinations of Need (DON) apply to ambulatory surgery centers (ASCs). The proposed regulations appear to have been written by someone trying to eliminate competition for hospitals.
The adverse regulatory environment in our Commonwealth has already reduced the number of ASCs from 63 in 2008 to 56 today. These remaining centers save the people of Massachusetts more than $150,000,000 annually compared to having the same services provided in a hospital outpatient departments. Additionally, ASCs provide these services with higher quality and greateraccessibility.
Unfortunately, the average hospital is responsible for 2 or more preventable deaths per month. In sharp contrast, freestanding surgery centers have only a small fraction of the infection and error rates that hospitals have and deliver the care at about half the cost. Independent surgery centers need to be encouraged by the state’s regulatory environment because this will reduce costs and improve the quality of care.
Requiring a DON and/or a hospital affiliation for ASCs to add equipment, change services, make capital expenditures, change location, or change ownership severely impedes ASCs from adapting to the dynamic needs of healthcare delivery. Technological advancements and innovation in technique are ongoing. ASCs have mostly been funded by private physician investors and their continued willingness to invest in our healthcare delivery at a competitive price point ought to be encouraged rather than restricted.
Massachusetts has the highest per capita healthcare expenditures of any state in the Union and among the lowest levels of provider competition. This is no coincidence.
For years, I’ve heard of the “No need. No file.” message being put out by the Department of Public Health to physician groups wanting to file for DONs so they can develop ASCs. While this does represent well the empire building interests of the state’s hospitals it is a disservice to the public that the DPH is supposed to be serving.
Please do not proceed with the proposed new regulations for Ambulatory Surgery Centers.
Sincerely,
Luke M. Lambert, CEO
Ambulatory Surgical Centers of America
cc: Charlie Baker, Boston Globe