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Hospital backlogs push parts of Mass. healthcare system into ‘high risk’

BOSTON — Major swaths of the state’s health care system are now considered “high risk,” with the crisis largely fueled by a major backlog of patients waiting to be discharged from hospitals, the Massachusetts Health and Hospital Association said Monday.

MHA indicated the situation is exacerbated by serious financial challenges at Steward Health Care, which on Friday said it doesn’t plan to close any of its safety-net hospitals in Massachusetts but hinted some facilities may eventually come under new ownership.

The Department of Public Health elevated the risk level of two medical regions -- the Boston metropolitan area and northeastern Massachusetts -- to Tier 3 last week, a designation that might result in hospitals slashing “elective, non-urgent procedures and services,” MHA said. A spokesperson for DPH said the new tier itself wouldn’t result in service reductions, but it’s a potential strategy that can be deployed to deal with capacity constraints.

Hospitals with the designation must also meet frequently to discuss bed availability, MHA said.

“It is indeed a crisis for those on the frontlines and the public can play a role in helping to alleviate the stresses hospitals are under,” Patricia Noga, MHA’s vice president of clinical affairs, said in the group’s newsletter Monday. “It’s imperative to seek the right care in the right place. Emergency departments will see any patient in need of care, but they are designed to handle severe illnesses and injuries that can’t be addressed in the primary or urgent care setting. Going elsewhere when appropriate saves you time and ensures that patients with true emergencies get the care they need, when they need it.”

The state makes its decisions about risk level tiering, using a scale of 0 to 4, based on risk factors such as a spike in certain diseases, staffing problems, emergency department usage and bed availability. DPH, in an alert sent to providers, said the new risk levels were being issued “in order to assure good situational awareness and rapid response for capacity constraints and workforce challenges.”

Other parts of the state, including southeastern Massachusetts and the Cape and Islands, have been assigned to Tier 3 since the start of 2023. The state in January outlined an agreement among hospitals, insurers and long-term care settings designed to more smoothly and efficiently move patients through hospitals.

The capacity crunch at hospitals is “made even more precarious due to the unstable finances and uncertainty surrounding the Steward Health Care system,” MHA said.

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