Massachusetts Lawmakers Critique CVS-Mass General Brigham Partnership

In a move that has sparked significant debate, a proposed partnership between Mass General Brigham (MGB) and CVS is facing skepticism from primary care physicians and state lawmakers. The collaboration aims to enhance access to comprehensive primary care in Massachusetts, but concerns are mounting regarding its implications for patient care.

Cindy Friedman, co-chair of the Health Care Financing Committee, expressed her surprise at the proposal, stating, “My first reaction was, this is not what we think about when we think about primary care.” She highlighted her concerns about the implications of the partnership, suggesting that it could dilute the essence of primary care.

Details of the Proposed Partnership

The partnership seeks state regulatory approval for a clinical affiliation that MGB and MinuteClinic claim will address gaps in primary care access. Currently, approximately 80 advanced practice providers (APPs) staff 37 CVS MinuteClinic locations across Massachusetts. The companies assert that the initiative will lower healthcare costs and cater to individuals who currently lack a primary care provider.

Critics, including primary care physician Dr. Chris Garofalo, have voiced concerns about the absence of traditional physicians in the proposed care model. “Extending primary care to a business such as CVS… would seemingly remove the physician from the equation,” Garofalo noted. He emphasized the importance of having a physician present in primary care settings, arguing that it is crucial for effective patient care.

The proposal does not involve expanding clinic locations or hiring additional staff, nor does MGB plan to invest funds into the partnership. Instead, it aims to utilize existing resources to enhance access to care.

Concerns About Care Quality

There is a growing anxiety among healthcare professionals about the adequacy of care provided by APPs in a MinuteClinic setting. Nurse practitioners in Massachusetts can operate independently of physicians, but some doctors, like Dr. Zoe Tseng from Brigham and Women’s Hospital, question whether APPs can effectively manage patient panels of 1,500 while maintaining quality care. “I think it’s highly doubtful that an APP would be able to carry a [full] patient panel… without a robust system,” Tseng commented.

According to CVS, MinuteClinic clinicians are board-certified medical professionals capable of managing comprehensive primary care, including preventive health visits and chronic disease management. However, skepticism remains regarding whether these practitioners can deliver the same level of care traditionally expected in a primary care setting.

Moreover, Friedman criticized the partnership as misleading, arguing that “what they’re talking about is just urgent care.” She stressed that true primary care fosters an enduring relationship between patient and provider, which she believes the CVS-MinuteClinic model lacks.

The Broader Context of Primary Care in Massachusetts

Massachusetts is currently grappling with a primary care crisis characterized by provider burnout and significant barriers to access, as identified by a recent report from the Health Policy Commission. The state has prioritized addressing this crisis, yet no comprehensive legislative proposals have emerged in the past several months.

Dr. Alan Sager, a health policy expert at Boston University, labeled the CVS-MGB proposal as “more primary care smoke and mirrors,” emphasizing the need for well-established primary care providers rather than episodic care offered in drug stores.

Trade and advocacy groups are urging for more transparency regarding the locations of new clinics. Amy Rosenthal, Executive Director of Health Care For All, expressed interest in the Health Policy Commission’s analysis of the proposal, particularly concerning its financial implications.

Should the partnership receive approval, MGB patients would gain in-network access to MinuteClinics, facilitating referrals to specialists and hospitals within the MGB system. However, some physicians worry that this could exacerbate existing access issues by increasing patient loads and wait times.

Friedman has proposed legislative changes aimed at stabilizing the primary care workforce and reducing administrative burdens, emphasizing the need for systemic reforms. “Get rid of the administrative burden and pay primary care practices enough that they can stay in business,” she urged.

The Health Policy Commission is expected to commence a 30-day review process on the partnership, following the submission of additional documentation. While the Commission lacks the authority to block such transactions, it can recommend action to other state agencies. CVS anticipates a decision from the Commission in the fourth quarter of 2025.

This proposed partnership raises critical questions about the future of primary care in Massachusetts and the balance between accessibility and quality. As discussions continue, the implications for patients and providers alike remain under scrutiny.