BOSTON — A proposed partnership between Mass General Brigham (MGB) and CVS is drawing significant criticism from primary care physicians and state lawmakers. The collaboration aims to enhance access to comprehensive primary care but raises concerns about the quality of care provided.
Senator Cindy Friedman, co-chair of the Health Care Financing Committee, expressed her initial reaction, stating, “I’m kind of blown away. This is not what we think about when we think about primary care.” The partnership seeks state regulatory approval for a clinical affiliation that both companies argue will help lower health care costs and improve access for underserved populations.
Currently, approximately 80 advanced practice providers (APPs) operate across 37 CVS MinuteClinic sites in Massachusetts. The proposal, filed with the Health Policy Commission on June 6, does not entail opening new clinics or hiring additional staff, nor does MGB plan to invest financially in the partnership.
Concerns have been raised about the role of APPs in providing primary care. Dr. Chris Garofalo, a primary care physician with over two decades of experience, noted, “Extending primary care to a business such as CVS through MinuteClinics, which typically only have nurse practitioners in them, would be a little concerning because it would seemingly remove the physician from the equation.” He emphasized the importance of having trained physicians involved in primary care.
In Massachusetts, nurse practitioners can practice independently, which allows them to provide certain medical services without direct supervision from a physician. CVS claims that clinicians at MinuteClinic sites would focus on preventive care, with services including same-day access and virtual consultations.
The state is currently facing a primary care crisis, with many patients relying on MinuteClinics either due to a lack of primary care providers or because they have not seen one in years. A report from the Health Policy Commission identified provider burnout and barriers to patient access as major contributors to the decline in primary care services.
Despite the urgency to address this issue, no comprehensive legislative proposal has emerged from the Massachusetts legislature after more than seven months of discussion. Friedman criticized the MGB-CVS proposal as “misleading,” arguing that it does not align with traditional notions of primary care. “What they’re talking about is just urgent care,” she stated. “We have systems in place for collaborative care. That isn’t going to happen in a CVS.”
The proposed structure would assign each APP a patient panel of approximately 1,500 patients, potentially increasing capacity for up to 120,000 patients statewide. Dr. Zoe Tseng of Brigham and Women’s Hospital expressed skepticism about whether APPs could adequately manage such a panel without a supportive system in place. “Quite honestly, our situation has shown that that is not possible without a good, robust system — and that’s what we’re really lacking right now,” she remarked.
Critics also question the effectiveness of MinuteClinic staff, who often have backgrounds in urgent care, in delivering comprehensive primary care. Tseng highlighted the lack of clarity in the proposal regarding collaboration and support for APPs, raising concerns about training and adherence to core principles of primary care.
CVS maintains that its MinuteClinic clinicians are “board-certified, highly trained medical professionals” capable of addressing primary care gaps. “We’d need to rely on experienced, salaried nurse practitioners who are already providing primary care,” commented Dr. Alan Sager, a health policy professor at Boston University, describing the proposal as “more primary care smoke and mirrors.”
Trade and advocacy organizations are monitoring the development closely. Amy Rosenthal, Executive Director of Health Care For All, expressed interest in understanding the proposed locations for new clinics and the potential cost implications.
According to an MGB spokesperson, the affiliation aims to expand access in regions with significant provider shortages and high rates of avoidable emergency department visits, including areas such as Worcester and Bristol counties.
In a statement, Dr. Olivia Liao, President of the Massachusetts Medical Society, emphasized the need for careful consideration of proposals aimed at improving primary care access. She stated, “We believe patients receive the best possible care when they are served by a physician-led team, supported by other health professionals.”
The Health Policy Commission is set to review the proposal. After additional paperwork is submitted, a 30-day review process will commence. While the HPC does not have the authority to block transactions, it can request that other state agencies take action.
CVS anticipates a decision from the Health Policy Commission in the fourth quarter of 2025. Should the affiliation receive approval, MGB patients would gain in-network primary care access at MinuteClinics, improving coordination with MGB hospitals, specialists, and diagnostic facilities.
Concerns remain, however, about the broader implications of the partnership. Dr. Andrew Cooper Warren from Brigham and Women’s Faulkner Hospital warned that increasing the number of patients in the specialist system could exacerbate wait times and access issues for all patients. He remarked, “This allows MGB to say, ‘Oh, guess what? We just expanded by X number of patients’ to the insurance companies, and then get paid for those people without actually spending any of their money.”
Friedman criticized the trend of consolidating healthcare services, suggesting that it primarily benefits businesses rather than patients. She advocates for systemic reforms to improve Massachusetts’ struggling primary care sector, proposing measures to reduce administrative burdens and enhance compensation for primary care practices.
The ongoing debate reflects the complexities of addressing the primary care crisis in Massachusetts, as stakeholders consider the best path forward for improving access and quality of care for patients across the state.