A highly-anticipated report expected to shape healthcare services in the Northern Berkshires following the March closure of North Adams Regional Hospital has been released.The 100-page report, including appendices, recommends limited inpatient services in Northern Berkshire County only if the site is federally designated as a critical access facility. Maine-based Stroudwater Associates issued the report, which was commissioned by the state and the Massachusetts Hospital Association.
North Adams Regional Hospital abruptly closed in March. Since then, Pittsfield-based Berkshire Health Systems has opened an emergency center at the facility; it went on to purchase the site from bankrupt Northern Berkshire Healthcare. Massachusetts Secretary of Health and Human Services John Polanowicz says the state will be involved if BHS pursues critical access status from the Centers for Medicaid and Medicare Services, noting the status is difficult to get.
“I know our office of rural health from the Department of Public Health would be supportive of putting our collective best foot forward to make that request of CMS,” said Polanowicz.
NARH failed to get the status in 2011. BHS spokesman Michael Leary has said the company plans to use the report as a guidepost.
“We will be reviewing the findings and recommendations in the weeks ahead as we continue to establish or re-establish healthcare services in Northern Berkshire through Berkshire Medical Center or in partnership with other agencies and organizations,” said Leary.
The report finds historically 144 people per every thousand were admitted to NARH for inpatient services, higher than the state level and the national rate, which is 121. It goes on to say the rate is expected to drop. The length of stay at NARH was about a day shorter than the market average. If an inpatient facility was set-up, the report recommends about 20 beds for acute care and 10 for behavioral health and substance abuse treatment. That type of facility in North County would cost BHS $2.1 million more per year than sustaining the current model. Stroudwater’s Brian Haapala says that number could increase by $700,000 over five years.
“The question really becomes, how do we contain healthcare costs if we go down that road?” Haapala said. “Maybe differently, if a portion of those resources were reinvested into some of the other recommendations of the report around community health, prevention and wellness, would we need even less inpatient capacity as is contemplated in this report.”
Polanowicz is looking more information on the estimated costs.
“I think that’s going to be a big question for people in the community,” Polanowicz said. “If we’re talking $2 million why wouldn’t we do something? I think it’s a broader issue than just that.”
The Massachusetts Nurses Association represents about 100 of the former 530 NBH employees. Spokesman David Schildmeier says whether BMC provides inpatient services shouldn’t be tied to critical access status and federal reimbursement rates.
“They can figure out a way and the state can provide we are sure if they are committed to it, to provide the services that are necessary,” Schildmeier said. “That’s the goal here. Not to be financially viable.”
The report recommends continued involvement by BHS and its ongoing emergency services as well as expanding diagnostic, outpatient and primary care options.
“People as much as I want to see as much back as humanly possible,” said North Adams Mayor Richard Alcombright. “But at the end of the day we have to make certain this succeeds and it sustains itself.”
The report says asthma, cancer and heart disease rates among the 37,000 people in Northern Berkshire are higher than the state average. It noted the region’s population is slowly declining, but the population of those 65 and older will increase nine percent over the next five years. It adds the region has a low-income population more than 10,400. These factors combine for what the report calls a “medically vulnerable population” dependent on government-reimbursed services.
Public meetings to discuss the report have been set for 5:30 September 23rd at Massachusetts College of Liberal Arts and September 24th at 9:30 a.m.
