Tufts Children's Hospital Closure

Decision Assessment & Competitive Analysis

The Decision

Outpatient Academic
Filled beds
care decisions affiliations

Loss of
Loss of
pediatric Culture
specialists
residency
 P E S T E L
Political Economic Social Technology Environment Legal

• Reimbursement • Increasing • Decreasing • Level of • Pollution • Pediatric-

rate for Medicaid pediatric automation • Traffic volume specific
Medicaid and population population • Telehealth • Personal vs public requirements
other gov’t plans • Lower incomes/ • (https://www.bo opportunities transportation • Antitrust issues
• Reimbursement lack disposable stonindicators.or • Expensive access • Consumer
differences income g/reports/report innovations • Aged facilities are protections
between adult • Higher inflation -website- • Peds-specific inefficient • Regulatory
and pediatric • Less healthcare pages/kids- technology restrictions on
inpatient beds expenditures today) • Keep the NICU telehealth
• Lack of • "First year of • Low population • Tech-savvy
legislative life" care is growth community
support for: expensive • Importance of
• pediatric care • Shift to patient-provider
• academic outpatient care bond
care • Covid-driven
• mental health financial losses
Porter's 5 Forces Analysis
Mostly Unwelcoming Environment

A few large customers

Buyer (Payor) (government payors);
Power High impact

Many large competitors Intensity of the

Threat of Substitutes available;
including a top tier; Competitive
High impact Substitutes Moderate impact
Landscape Tufts Children's
Hospital

Many suppliers in Strong barriers to entry for

common;
Level of New Entrants new entrants;
Low impact Supplier Power Low impact
 Pediatric Hospitals
in Boston Metro
A survey of providers
Distance to Tufts Surveyed Number of Peds
(time to drive Pediatric Sub-Specialties
& miles) Centers in Range Available
7 min 3 144, 28, 8
1.3 to 1.7 mi (no overlap)
8 – 20 min 3 22, 8, 5
3.4 to 5.0 mi (overlap: 3)
21 – 30 min 7 97, 59, 52, 48, 7,
10.4 to 21.5 mi 3, 3
(significant
overlap)
33 – 60 min 6 58, 46, 26, 10, 9,
22.7 to 53 mi 3
(some overlap)
65 – 150 min 4 47, 24, 3, 2
59.9 to 152 min
 Direct Competitor Assessment

Boston Children's Hospital Mass General for Children Shriners Children's Boston
– Mass General Brigham

Strengths: Strengths: Strengths:

• #1 ranked Children's Hospital by U.S. News & World • Large group with pediatric ER/only • Only pediatric verified burn hospital in New
Report proton beam building in New England
• Harvard-affiliated England • Highly focused specialty care – cleft lip and palate
• National/Global market • Harvard-affiliated care, plastic surgery, wound care
• Relationships with 78 academic and medical
institutions including Mass Gen, Harvard, BCH,
and Mayo Clinic Care Network
Weaknesses: Weaknesses: Weaknesses:
• Continuum of care for children with medically • Not exclusively focused on pediatric • Doesn't have major service lines
complex needs care like ER/Behavioral/Oncology
• Relatively small 30 bed hospital
Recent Action: Partnership/acquisition of Franciscan
Children's Hospital; announced Fall 2021
Ambitions: Ambitions: Ambitions:
Expanding service line availability, beds, and network Continue expansion push and maintain Continue social mission of providing care for children
high reimbursement rates with neuromusculoskeletal conditions and burn
injuries.
 Boston Children's

Competitor Mind Map

Shriner's Children's
Direct Competitors

Mass General Children's

Texas Children's

Boston Medical Pediatrics

Children's Hospital of
Philadelphia Tufts
Children's
Indirect Competitors Competitors Cape Cod Pediatrics

Cincinnati Children's

Hasbro Children's
Potential Competitors
Mayo Clinic Children's Yale New Haven Children's

Newborn Developmental
 MILES FROM NUMBER OF NUMBER OF SPECIALTIES COST OF CARE
Competitor Radar Chart TUFTS C.H. PEDIATRIC PHYSICIANS
Select Data BEDS (NETWORK)

/ = change in time*
BOSTON CHILDREN'S HOSPITAL
Sustained Competitive Advantage 2.5 415/475/500+ 300+ 258 95th percentile+
Differentiation Focus
BOSTON MEDICAL CENTER PEDIATRICS
Competitive Advantage 1.2 30-50 71 36 60th percentile
Cost Focus
MASS GENERAL HOSPITAL FOR CHILDREN
Sustained Competitive Advantage 2.2 100 300+ 50 90th percentile
Differentiation
YALE NEW HAVEN'S CHILDREN'S HOSPITAL (CT)
Competitive Advantage 115 202 212 60 75th percentile
Differentiation
50th
TUFTS CHILDREN'S HOSPITAL 0 128/41/0* 84/140/0* 42 percentile/0*
Cost Leadership
Competitor Radar Chart • Distance from Tufts Children’s
Boston Children’s Hospital

Boston Medical Center Pediatrics

Mass General Hospital for Children

Tufts Children’s Hospital
Yale New Haven’s Children’s Hospital

• Cost of Care • Number of Pediatric Beds

• Specialized Clinical Programs

• Number of Physicians
SPOTLIGHT: A NEW BOSTON CHILDREN'S
HOSPITAL PEDIATRICS FACILITY

The Hale Family Building

• 11 floor, 595K sq ft tertiary & quaternary care

• 2.8 miles from the former TCH (17 minutes by car)

Focused patient experience:
• 150 private inpatient rooms, including: • 700+ pieces of artwork
• 15 next-generation high-tech operating rooms • 28K sq ft green spaces inside and out
• Info-sharing hubs
• State-of-the-art 30 bed NICU with private rooms for
patients a single family member
• Comprehensive and integrated “Heart Center” 96
private inpatient rooms, 21 exam rooms and 9 pre-
op exam rooms
• Modern laboratory with extensive automation lines
Tufts Children’s Hospital Closure

Recap
Retrenchment Strategy
• Existed in a niche market near the top US competitor
• Transitioned physician services to capable competitors
• Unable to sustain best cost leadership to dependent locals
• Reputation and social mission compromised
• Integral for many years to the fabric of Boston
• Well deployed strategy by Tufts Medical Center
• Closure provided defensive security for other Tufts Medical branches