BRMC's troubles are still mounting
Published on January 13th, 1999
STONEHAM, MA - The past year has been a tumultuous one for Boston Regional Medical Center (BRMC) and for those that work there. The Town of Stoneham and many creditors have been banging on the doors of hospital administrators in hopes of recovering some of the money for services which have been rendered to the hospital on credit. The sale of the hospital to Doctors Corporation of America which, last March, appeared imminent has yet to come to fruition. Residents of BRMC's land, some of which had lived on the property for 30 years, complained that their landlord and, in many instances, former employer was kicking them out of their homes and treating them unjustly. Just two weeks ago, it was reported that a woman had been inseminated at the hospital's fertility clinic with the wrong sperm. The hospital failed to notify the Department of Public Health until two weeks later, well after the state mandate of seven days for such action.
The most recent troubles for BRMC came last week when Tufts Health Plan dropped the hospital from its coverage of fertility treatment centers. Although the insurance company has agreed to continue paying the bills of couples currently seeking help at BRMC's fertility clinic, the company does not recommend nor will it cover any future insemination procedures conducted at the Woodland Road facility.
According to Michelle Davis, Tufts' Director of Public Relations, the company's action came at the heels of an extensive quality assurance investigation of nine major area fertility clinics. Davis said that Tufts conducted this research due to the lack of similar watchdog programs by the state and federal governments.
Of the nine, three failed to meet the company's "lengthy set of quality-based criteria," Davis said.
Aside from BRMC, Reading's Fertility Center of New England and the Faulkner Hospital in Jamaica Plain were seen as lacking in at least one of the company's five basic criteria.
"They didn't make all five," Davis said of Tufts' review of the BRMC fertility clinic. "They (those that were reviewed) had to make all five to qualify for our health plan."
Davis explained that consultants determined the basic criteria (live births per cycle, number of procedures performed by hospital physicians, board certification of clinic employees, level of experience in lab staff and the licensing of the lab) and then reviewed the nine clinics. The six clinics which passed the test are: Baystate Health Systems IVF Clinic in Springfield; Boston IVF Inc. in Brookline; Brigham and Women's Hospital Center for Reproductive Medicine in Boston; Massachusetts General Hospital Vincent IVF Unit in Boston; Reproductive Science Center of Boston in Waltham; and Women's and Infants' Reproductive Therapies Program in Providence, RI.
When asked if Tufts' decision was based in any way on the botched insemination procedure performed at the clinic on December 4, Davis said, "That would be something that we'd pay close attention to. I don't think she (the patient) was a Tufts member. In fact, I know she wasn't a Tufts member, but what happens is we read the (news)paper and take note.
"That (incident) did not have anything to do with our decision making.
According to BRMC spokeswoman Christine Hawrylak, the Tufts critiques were based on 1996 statistics. Although Tufts declined to release information on which areas the BRMC clinic was lacking, Hawrylak speculated that a major area of concern was the lack of board certified physicians.
She said that the hospital has recently revamped its clinical team which now includes two new certified physicians and a new medical director. This move has also helped the clinic's other likely shortcoming, percentage of conceptions.
"I think we feel we can do a better job with the percentages now that we have the certified physicians on board. The success rate changes from year to year. I think volume has a lot to do with it. I don't think that we had the volume (large number of patients) that some of the other centers did.
"Obviously, we're unhappy that we don't have the contract (from Tufts)," Hawrylak continued. "The centers outcome rate (live births per cycle) has improved over the past two years.
"We're confident that we can meet Tufts standards now."
She said that about 20 percent of the clinic's clientele are covered under Tufts' plans.
Lorie Miller, executive director of Boston Regional Medical Associates, also said that the HMO's new criteria, believed to be the first insurance-imposed standards on the industry in the country, could have profound and unfortunate consequences for patients. Since one of the criteria used is based on a clinic's success rate, hospitals may be forced to turn down patients who have a below-average likelihood of conceiving for fear of losing out on their piece of Tufts' pie.
"The downside to Tufts' decision is that some of the women who would have gotten a chance to use our technology wouldn't now have that opportunity," Miller said. "That's regrettable from a personal basis. It's regrettable from a patient's perspective as well."
While BRMC expects to lose some business due to this latest hurdle, she said that the future looks bright for the fertility clinic. It is expected, Miller explained, that the BRMC fertility center, which performed 435 insemination procedures in 1998, will join with that of Lahey Clinic within the next year.
Subscribe and get Home Delivery of The Independent
Save 36% off the newstand price — that's like 18 FREE issues!