BOSTON — A proposed partnership between Mass General Brigham (MGB) and CVS MinuteClinic is facing significant scrutiny from primary care physicians and state lawmakers. The collaboration aims to address gaps in primary care access in Massachusetts, but critics are raising concerns about its implications for patient care.
Senator Cindy Friedman, co-chair of the Health Care Financing Committee, expressed her disbelief regarding the proposal. “My first reaction was, this is not what we think about when we think about primary care,” she stated. The affiliation seeks state regulatory approval to enhance primary care services but does not plan to open new clinics or hire additional staff.
Currently, approximately 80 advanced practice providers (APPs) work across 37 CVS MinuteClinic locations in Massachusetts, as outlined in documents submitted to the Health Policy Commission. The partnership is positioned as a strategy to lower health care costs and improve access for patients without a primary care provider.
Critics argue that relying on MinuteClinics, which typically employ nurse practitioners, could dilute the quality of primary care. Dr. Chris Garofalo, a primary care physician with over two decades of experience, voiced concerns about the absence of physicians in this model. “When you leave the physician out of it, I’m not so sure that’s the direction we should be going in,” he noted.
The proposal suggests that clinicians at MinuteClinics will manage comprehensive care, focusing on prevention, routine health maintenance, and chronic condition management. According to CVS, the services will include same-day access, extended hours, and virtual care. The term “advanced practice provider” includes nurse practitioners and physician associates, who are legally allowed to practice independently in Massachusetts.
Massachusetts is currently facing a primary care crisis, with many patients either lacking a primary care provider or not having seen one in years. A report from the Health Policy Commission identified provider burnout and barriers to patient access as significant contributors to the sector’s struggles. Meanwhile, a task force is working on solutions, including investments and workforce strategies.
Despite the attention on primary care, no concrete legislative proposals have emerged from state lawmakers, more than seven months into the session. Friedman described the MGB-CVS plan as “misleading,” emphasizing the importance of the provider-patient relationship in effective primary care. “What they’re talking about is just urgent care,” she asserted, highlighting the need for a collaborative care system that MinuteClinics may not provide.
Some health professionals believe that incorporating nurse practitioners and physician associates into the healthcare landscape can help bridge access gaps. The proposal indicates that each clinician would manage a patient panel of about 1,500 patients, potentially accommodating an additional 120,000 patients statewide. However, Dr. Zoe Tseng, a primary care physician at Brigham and Women’s, expressed skepticism about the feasibility of these numbers, citing the need for a robust support system to ensure quality care.
Dr. Tseng, who has been with Brigham and Women’s for 11 years, noted the administrative challenges that primary care providers face. “Unless it’s proven to work, I don’t know why they’re rolling it out in such a large capacity,” she stated, emphasizing the risk of further fragmentation in primary care delivery.
CVS maintains that its MinuteClinic clinicians are “board-certified, highly trained medical professionals” capable of addressing primary care access issues. The company pointed out that nurse practitioners can perform many functions traditionally associated with physicians, including diagnosing and treating illnesses.
Critics like Dr. Alan Sager, a professor at Boston University, have dismissed the proposal as “more primary care smoke and mirrors.” He emphasized the need for experienced nurse practitioners to provide consistent primary care, rather than episodic treatment in drug stores.
Advocacy groups are awaiting more details on the proposal. Amy Rosenthal, Executive Director of Health Care For All, expressed interest in understanding the locations of the proposed clinics and looks forward to a thorough analysis from the Health Policy Commission.
According to a spokesperson for MGB, the collaboration aims to increase access in regions with high provider shortages, particularly in areas like Worcester and Bristol counties. Dr. Olivia Liao, president of the Massachusetts Medical Society, underscored the importance of physician-led teams in delivering optimal patient care. She called for thoughtful consideration of any proposals that could enhance primary care access.
The Health Policy Commission will review the proposal, initiating a 30-day review process once additional paperwork is submitted. While the commission lacks the authority to block the partnership, it can recommend actions to other state agencies. CVS anticipates a decision from the commission during the fourth quarter of 2025.
Should the affiliation receive approval, patients under MGB could access in-network primary care at MinuteClinics, which would facilitate coordination with MGB hospitals and specialists for comprehensive care. However, concerns persist regarding the potential for increased wait times for patients seeking specialists, as highlighted by Dr. Andrew Cooper Warren, a primary care physician at Brigham and Women’s Faulkner.
Warren cautioned that the partnership may allow MGB to claim an expanded patient base without making significant investments in resources. “This allows MGB to say, ‘Oh, guess what? We just expanded by X number of patients’ to the insurance companies,” he explained.
Friedman criticized the proposal, asserting that it reflects a broader trend of healthcare consolidation that fails to benefit patients. She proposed reforms to address the underlying issues within Massachusetts’ primary care sector, advocating for reduced administrative burdens and improved compensation for primary care practices.
Her bill, S 867, aims to establish primary care spending requirements and create a stable workforce, but it has faced hurdles in the legislative process. “This is not primary care,” she reiterated, emphasizing the need for a definition of primary care that encompasses the continuum of patient care from birth to end of life.
As CVS continues to expand its MinuteClinic model in various states, including Texas and California, the implications of the MGB partnership will be closely monitored by stakeholders across the healthcare landscape.
