Full Breakdown
Mass General Brigham Announces New Layoffs and Major Reduction of Home Hospital Program
By Drooid · · How we work
Core Event: Layoffs and Home-Hospital Cutbacks
Mass General Brigham (MGB), the state’s largest health-care system, began a new round of employee reductions last week. The system did not disclose the total number of positions eliminated, but confirmed that pediatricians at Mass Eye and Ear are among those affected. Simultaneously, MGB plans to sharply curtail its nine-year-old Home Hospital program, limiting future enrollment to no more than 30 patients—a reduction from roughly 70 patients served in 2024.
Background & Context
The Home Hospital model, launched in 2017, allows clinicians to deliver hospital-level care in patients’ residences, using daily in-person visits and tele-medicine support. During the COVID-19 pandemic, the program expanded as a “release valve” for strained inpatient capacity after the Centers for Medicare & Medicaid Services (CMS) authorized it as part of a five-year experimental waiver. The waiver expired in 2025 during a prolonged federal shutdown, briefly halting admissions before Congress extended it through 2030. MGB’s 2024 news release described the service as “essential” and reported that between 2022 and 2024 the program served over 4,000 patients.
Data & Statistics
- Operating margin for fiscal 2025: 0.3 % of operating revenue (? $59 million).
- Target operating margin: 1.5 % (? $300 million).
- Fiscal 2025 surplus: $2.38 billion, largely from investment income not earmarked for operations.
- Home Hospital financial loss: $30 million per year on average over the past three years.
- Patient outcomes (Massachusetts Health Policy Commission): discharge to skilled-nursing facilities < 1 % for Home Hospital patients versus 11 % for traditional in-hospital patients.
Official Statements & Responses
A MGB spokesperson said the changes aim to create “a more focused, sustainable service” that prioritizes the sickest patients while preserving the program’s proven clinical benefits. The spokesperson added that the system is “strengthening long-term financial sustainability” by improving coordination across hospitals and accelerating integration of care settings. The statement emphasized that the cuts are “difficult but necessary decisions” to maintain exceptional patient care, research, education, and mission-critical programs.
On-the-Ground Reports
Front-line clinicians reported low morale amid the layoffs, describing a climate of uncertainty and fear of further job loss. One physician noted that the reduced capacity of the Home Hospital program undermines a key strategy for freeing inpatient beds, especially as the system anticipates a surge in uninsured patients after new Medicaid work requirements take effect. Staff at Salem Hospital, Newton-Wellesley Hospital, and Brigham and Women’s Faulkner Hospital reported that clinical operations for Home Hospital have been indefinitely paused at those sites.
What’s Next
MGB plans to implement the Home Hospital reduction in the coming month, with the program refocused to support Massachusetts General Hospital and Brigham and Women’s Hospital. The system also indicated that pediatric inpatient services will be consolidated at other network hospitals later this year. Meanwhile, the organization faces a potential nurses’ strike, as rising labor, pharmaceutical, and other costs coincide with stagnant Medicare, Medicaid, and commercial reimbursements.