Doctors are warning the Steward Health financial crisis threatening hospitals across the state may wear away at the vital link between community hospitals and cancer treatment — widening potentially fatal gaps in cancer detection and treatment.
Steward Health Care, a Dallas-based private equity health system that owns eight operational hospitals in Massachusetts, has been scrutinized over widespread financial mismanagement, leaving its hospitals’ future shrouded in uncertainty since December.
The financial constraints and potential closures threaten thousands of patients’ vital care forcing the Healey administration to launch an “Emergency Operations Plan” Friday.
When it comes to catching cancer, one Dana-Farber doctor said community hospitals simply save lives.
“A woman in small cell lung cancer, she came in, and generally small cell lung cancer is a very poor prognosis, especially when it’s extensive stage,” said Dr. Christopher Lathan, chief clinical access and equity officer and associate medical director at Dana-Farber Cancer Institute. “And we have been really fortunate in her treatment that she has not only survived longer than people would have expected but that she’s been off therapy now for almost four years and still continues to have no evidence of disease.
“And she was seen, treated and evaluated actually at St. Elizabeth’s,” Latham said of the Brighton hospital.
Dana-Farber has direct partnerships with Steward’s St. Elizabeth’s and Methuen’s Holy Family facilities, but many more community hospitals play roles in corraling cancer and helping patients access treatment, Latham said.
Cancer tends to be caught early and diagnosed in settings like community hospitals where patients are regularly treated closer to home, Latham said. Taking out community hospitals like Steward’s is “very impactful” to people with cancer, pushing particularly vulnerable patients father from accessible local care, providers they have relationships with and trust, and affordable care.
“I have really focused on access to care for poor folks, for Black and Brown communities and immigrant communities,” said Latham. “What you see for our community hospitals — this is true for most of the community hospitals, but many of them in a Steward network — they’re taking care of a patient population that has the highest poverty level and that has the lowest resources.”
Dana-Farber found when the institute partnered with a community hospital, the “co-location model” reduced time to cancer diagnosis from a median of 32 days to 12 days compared to diagnosing only within the Boston campus.
Even just moving a patient’s care from St. Elizabeth’s in Brighton to the Longwood Medical Campus in Fenway, a 15-minute move, can create “delays in care” for patients, Latham said.
Research has found is it also significantly less expensive to be treated in a community hospital than a larger hospital. An analysis from the Massachusetts Center for Health Information and Analysis (CHIA), care at community hospitals cost about 7% less than the statewide average in 2021. Academic medical centers cost 9% more than the statewide average.
The financial crisis at Steward has led to challenges in delivering care, Latham added, as well as widespread morale issues among staff and patients.
“I’ve had patients who come to see me in the oncology clinic in St. Elizabeth’s, where we’re in the hospital, physically, some of the patients will come and say, ‘Hey, what does this mean? Are you going to be here? Am I going to be able to see you? Is my care going to be disrupted?’” said Latham.
The Boston-based cancer institute is guaranteeing none of its patients will lose access to care if any of the Steward hospitals close down and planning for contingencies. But Latham said he can’t tell patients what the “long-term issues will be” as the future of their local care balances precariously.
Financial issues for community hospitals spread beyond the Steward crisis, affecting everyday patient care across the state.
“That’s the role of this community hospital serve — they serve the community in a very deep and enduring way because they’ve been there and this is where people have been going for years,” Latham said. “And it’s nearby, transportation issues, access, all those things are really important. So they really do an incredible role in in to being the first place where many people go for the screening and early treatment.”
Steward facilities include Carney Hospital in Dorchester, Good Samaritan Medical Center in Brockton, Holyoke Hospitals in Haverhill and Methuen, Morton Hospital in Taunton, Nashoba Valley Medical Center in Ayer, Saint Anne’s Hospital in Fall River and St. Elizabeth’s Medical Center in Brighton. Their Norwood Hospital has been closed since 2020 due to flooding, and the company recently closed New England Sinai Hospital permanently.
