Massachusetts insurers seek independent study of what mandated nurse staffing would cost

Massachusetts insurers are seeking an independent study on the financial effect of the proposed November statewide ballot initiative to mandate nurse staffing ratios in hospitals.

The Massachusetts Association of Health Plans, which represents 16 health plans, penned a letter to the state's health policy commission, asking the commission to "estimate what, if any, increase in spending would result from passage of the" ballot initiative, as well as "the likely per member per month impact."

The association said it also "would like to understand how increases in better quality of care might offset this spending."

"It is critical we have a credible, independent analysis that evaluates the true impact of the [ballot] question as it relates to costs, quality of care, access to care and the overall patient experience," the letter states. "Since no robust independent study has emerged in Massachusetts to provide these details, it is our belief that the HPC is in the best position to provide this analysis in a fair and thorough way."

Question 1, proposed by the Massachusetts Nurses Association, calls for mandated nurse staffing ratios that would vary by unit, floor or department.

Supporters argue mandated nurse staffing ratios will improve patient care, and opponents say the ratios will worsen nurse care delivery, lead to longer emergency room wait times, and hurt community hospitals and mental health facilities.

The Massachusetts hospital industry and Massachusetts Nurses Association have differing views on the estimated financial effect of Question 1. Hospital executives opposed to the ballot initiative cite a study by Mass Insight Global Partnerships and BW Research Partnership. The study, commissioned by the Massachusetts Health and Hospital Association, estimated mandated nurse staffing ratios would cost the state's healthcare system $1.3 billion in the first year and at least $900 million per year after that. 

The union cites a study it backed by Judith Shindul-Rothschild, PhD, RN, a nursing economist at Boston College, which estimated mandated nurse staffing ratios would cost Massachusetts acute care hospitals between $35.1 million and $46.8 million.

Massachusetts insurers said that if higher cost estimates are near accurate, "the question could significantly hamper our state's efforts to control cost and would threaten our state's ability to meet the healthcare cost benchmark."

The association requested that the health policy commission complete an analysis before Oct. 16-17.

 

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