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Massachusetts
The primary care system in Massachusetts is broken and getting worse, new state report says – The Boston Globe
Primary care, the foundation of the state’s health care industry, is crumbling, and Massachusetts is running out of time to fix it, according to a report published Thursday by the state’s Health Policy Commission, which sounded the alarm on many ways the front door to the health care industry is broken.
Among the problems: high and growing rates of residents reporting difficulty accessing primary care; an aging and increasingly dissatisfied physician workforce; and an anemic pipeline of new clinicians.
“I worry when I look at some of this data that the state of primary care has crossed a line from which recovery will be very difficult, unless we take action soon,” the commission’s executive director, David Seltz, said in an interview.
The report sets the stage for the work of a new state-appointed primary care task force, created by a health care law signed earlier this month. The law outlines that the new 25-member group will consider issuing recommendations related to increasing recruitment and retention of the primary care workforce and establishing a target for how much insurers should spend on primary care.
Such goals would put Massachusetts more in line with other states, including California, Oregon, Rhode Island, and Washington, which have set benchmarks for primary care spending. Seltz called such efforts an important way to rebalance the incentives of the market.
“This is an opportunity to shift the dialogue, to one of: ‘What can we do immediately to relieve this deep challenge?’” Seltz said.
While the findings set the stage for reform, they are perhaps not a surprise. Previous reports on primary care have been blaring the warning signal for years. Increasingly high portions of residents have said they had difficulty accessing health care. Analysis on health care spending has shown dwindling amounts of health care dollars going to primary care.
But the report lays out in stark terms just how dire the prognosis on primary care is.
Among the findings:
- Patients’ ability to access primary care is bad and getting worse. New patients must wait an average of 40 days in Boston, twice as long as the average of 15 other cities studied. Access to primary care worsened across the state in recent years, with such issues especially pronounced in lower-income communities.
- A lack of primary care access means more reliance on emergency departments, which are more costly places to get care. In 2023, a whopping two-thirds of those who sought care in hospitals’ emergency departments said they were there because they couldn’t get an appointment in a doctor’s office or clinic.
- Massachusetts has a lot of doctors — the highest total physicians per capita in the country. However the vast majority of those physicians are specialists. Compared to other states, Massachusetts has the fifth lowest share of primary care physicians.
- The primary care workforce is aging, with an estimated half of primary care physicians over the age of 55.
- The pipeline for new primary care doctors is dwindling, with only one in seven new Massachusetts physicians in 2021 going into primary care — among the lowest share in the country.
A primary driver of the current challenge is related to the low reimbursement rates primary care receives relative to other specialties and hospital services, the report states, a factor that disincentivizes both new graduates from entering the field and the health care industry from investing in it.
Beyond the low pay, primary care can be an exhausting job, requiring myriad billing and administrative tasks, increased documentation requirements, and visits too short to accommodate the core point of primary care — caring for the patient.
Dr. Alecia McGregor, a commissioner and an assistant professor at the Harvard T.H. Chan School of Public Health, noted the state is seeing evidence of that very burnout and corporatization of medicine, with both those complaints cited as key reasons primary care doctors at Mass General Brigham recently filed to unionize.
The state is currently making up for primary care physician shortages by leaning more on nurse practitioners and physician assistants, together known as “advanced practice providers.” However the share of even those providers working in primary care is dropping, in part because of the low pay.
“Relying on advanced practice providers to serve as (primary care providers) instead of physicians may not resolve challenges related to the availability of providers if we can’t improve job sustainability in the field of primary care,” said Sasha Albert, associate director of research and cost trends at the Health Policy Commission, during a presentation at Thursday’s commission meeting.
Beyond setting the stage for a new task force, Commissioner Tim Foley said the “scary” report emphasized the importance of the commission remaining focused on drivers of the recruitment and retention challenges.
“It just highlights again our need to continue to focus on the workforce issues,” said Foley, who is also the head of union 1199SEIU, which represents health care workers. “We had the hearing on the impact of the workforce, and it hasn’t gotten any better. It’s probably gotten worse.”
Jessica Bartlett can be reached at jessica.bartlett@globe.com. Follow her @ByJessBartlett.
BOSTON, MA — An international restaurant group with locations across the globe is preparing to open its first Massachusetts restaurant this year.
LPM Restaurant & Bar, a French Riviera-inspired restaurant founded in London, is set to open on the second floor of the Four Seasons Hotel One Dalton Street in Back Bay, according to Four Seasons. The hotel lists the restaurant as “Opening Summer 2026,” while the Boston Business Journal reported the restaurant plans to open in September.
The Boston restaurant will mark LPM’s debut in the Northeast and its third U.S. outpost, following locations in Miami and Las Vegas, according to a Four Seasons announcement.
LPM, also known as La Petite Maison, was founded in London in 2007 and is known for French-Mediterranean food, Mediterranean ingredients and dining rooms influenced by Belle Époque design.
The business operates locations in London, Dubai, Miami, Abu Dhabi, Hong Kong, Riyadh, Limassol, Doha, Mykonos, Kuwait, Boston, Maldives and Bangkok.
Four Seasons said LPM will take over the space that formerly housed One Dalton’s breakfast concept, One + One. The restaurant will join other dining options at the hotel, including Zuma and Trifecta.
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Massachusetts
Massachusetts high school under investigation after teachers diagnosed with breast cancer
A Massachusetts high school is under investigation after “several” teachers have been diagnosed with breast cancer or precancerous conditions.
The state Department of Public Health is set to visit Uxbridge High School on Thursday to “conduct a series of air quality tests,” to determine whether the multiple cases are potentially connected.
Superintendent David Ljungberg and Principal Michael Rubin alerted families and district staff on Monday of the “sombering news,” after Uxbridge High School’s graduation over the weekend.
“We are writing to inform you about a concern we are investigating at Uxbridge High School,” Ljungberg and Rubin stated in the letter. “Several female teachers have been diagnosed with breast cancer or precancerous conditions over the past few years.”
“It is, of course, possible that these multiple cases are not connected to one another,” the leaders added, “but out of abundance of caution, we are looking into any environmental factors at the school that may be a factor in their diagnoses.”
The 123,000-square-foot school, with an enrollment of roughly 600, was constructed in 2012 at a cost of $45 million, including a $22-million state reimbursement.
Uxbridge school leaders say they notified the state Department of Health and local health board as soon as they became aware of the cases, seeking “counsel about how best to proceed.”
“Massachusetts DPH officials have indicated that there is no evidence of immediate danger in the building and no reason to limit access to or use of the facility at this time,” they wrote in their letter. “In fact, the public health officials have commended our decision to approach them with these concerns, our readiness to partner with them in support of the evaluation process.”
Health officials are assessing the school’s interior and exterior to “ensure there are no issues with the infrastructure that would present risks (including electrical, plumbing, mechanical, HVAC, and other systems)” and the indoor and outdoor air quality on campus.
The superintendent and principal said that state officials have ruled out water supply as a “risk factor” after “thorough testing.”
“The team has reached out to the women who have been diagnosed, requesting data to evaluate whether there may be a connection among their cases,” Ljungberg and Rubin wrote. “We are grateful for their cooperation.”
They added that the state has said discovering an environmental “smoking gun” is “rare” in workplace investigations.
“However, even if a direct causal link is not established,” the leaders wrote, “the administration is utilizing this process to rigorously test the building and guarantee that it meets all safety standards moving forward.”
Local News
The legislation would allow licensed establishments to sell alcohol one hour later than their normal closing time, up to 3 a.m., between June 1 and Aug. 31, 2026.
Massachusetts lawmakers are considering a measure that would allow cities and towns to temporarily extend bar and restaurant hours during the summer, as the state prepares to host FIFA World Cup matches and celebrations marking the nation’s 250th anniversary.
The legislation (H.5465) filed by state Rep. Carole Fiola, would allow licensed establishments to sell alcohol one hour later than their normal closing time, up to 3 a.m., between June 1 and Aug. 31, 2026. The bill would also allow communities to establish designated public consumption districts where alcohol could be consumed in approved public spaces.
In a press release announcing the bill, Fiola said the summer’s threefold events lineup — the World Cup, Tall Ships, and July 4th — is an economically significant moment that the state should take advantage of.
“We should capitalize on these events that will generate economic benefits for small businesses and the state as a whole. It’s a local opt-in idea worth exploring that’s being done in other states,” Fiola said.
The proposal has received support from Boston Mayor Michelle Wu and most recently Gov. Maura Healey, who submitted written testimony Monday to the Joint Committee on Economic Development and Emerging Technologies urging lawmakers to advance the measure.
“Massachusetts is planning for a once-in-a-generation summer,” Healey wrote, according to the Boston Globe. “In 2026, we will celebrate the 250th anniversary of our nation’s founding, welcome tall ships from around the world to Boston Harbor for Sail Boston, and host seven FIFA World Cup matches in Foxborough, along with watch parties across the Commonwealth.”
The governor argued that the added flexibility could help local economies benefit from an influx of visitors.
“That flexibility can help communities capture more visitor spending, support jobs, keep downtowns active, and strengthen Massachusetts’ image as a dynamic destination ready to host the world and a place our residents, including our young professionals, are proud to call home,” Healey wrote.
She also urged lawmakers to move the legislation forward, saying it will “help Massachusetts meet the full economic and cultural opportunities for the summer ahead.”
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Rhode Island bill proposes 24-hour bar hours during World Cup
In Rhode Island, a similar bill to allow bars and restaurants to remain open until 4 a.m. during the World Cup was signed into law on Friday.
Fiola’s bill remains before the Joint Committee on Economic Development and Emerging Technologies. Any final version would require approval from both the House and Senate before reaching Healey’s desk.
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