Previously on this blog, we explained the deleterious impact the government-mandated nursing ratios included in Massachusetts Ballot Question 1 will have on patient care. There are numerous damaging effects that these artificial, one-size-fits-all ratios will have on health care quality and access, particularly in the area of behavioral health and rehabilitation. As the independent Health Policy Commission (HPC) pointed out in its recent analysis, the measure will have substantial dollar costs as well, in the form of hiring and implementation spending that will be passed onto taxpayers.

The HPC’s estimated annual costs—in the range of $676 million to $949 million—are in line with hospital industry’s own cost-benefit analysis.

What’s most problematic about this spending is that there’s little evidence that it would deliver a healthy return on investment in the form of enhanced care.

Massachusetts’ nursing staff levels are higher than national averages, and our quality is among the tops in the nation. Massachusetts staffing levels are higher than in California, the only state with an existing nurse staffing ratio mandate. Massachusetts’ hospitals’ quality and safety measures rank higher than California’s as well.

Staffing demands will cause untenable cost pressures resulting in stretched resources and the inevitable shuttering of services. Specifically, this legislation would impact night shift staffing and community hospitals, where rising costs are already felt most acutely.

In fact, Governor Charlie Baker this week came out in opposition to Question One for many of the same reasons highlighted here.

For the Commonwealth’s health care ecosystem, this measure simply does not meet the basic test of the value-driven system we all envision: evidence-based investments with proven benefits for patient outcomes.

This is why we will continue to advocate for a “No” vote on Election Day, November 6.

Read more about the impacts that Question 1 would have on the Commonwealth at the Coalition to Protect Patient Safety.

Topics: Patient Experience, Health Professions, Legislation

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