After several days of fielding criticism about the move behind the scenes, Gov. Maura Healey on Friday named the state's top hospital lobbyist to a position at the regulatory agency that oversees virtually all major health care decisions -- including those directly affecting his clients -- in Massachusetts.
Healey appointed six people to the Health Policy Commission's board of directors, including Massachusetts Health and Hospital Association President Steve Walsh, punctuating a flood of hand-wringing from business leaders, health care advocates and other segments of the industry worried about a potential conflict of interest.
The Healey administration defended the selection of Walsh, saying he fulfills a statutory requirement for a member of the HPC's board to come from a hospital background. Other board seats intended to represent segments of the health care world went to a Biogen executive and the former chief financial officer of two major insurers' parent company.
Walsh, who played an integral role in creation of the Health Policy Commission when he was a state representative, acknowledged in a disclosure form that hospitals and provider organizations with "business before the HPC" pay dues to his trade group to advocate on their behalf.
He wrote that he would be "internally walled off from MHA matters that are expected to come before the HPC for final approval." Walsh intends to recuse himself during HPC meetings on any matters involving material change notices, determination of need applications, and performance improvement plans submitted by MHA members. He said he also plans to work with the agency's general counsel to determine if other steps are necessary to deal with "competitively sensitive information."
In an interview, Walsh said he "certainly appreciate[s] and respect[s]" the concerns that some stakeholders raised about his appointment.
"Hopefully, the disclosure that I filed will alleviate some of those concerns. I'm privileged to be appointed by the governor to this role as an individual to bring my perspective on health care from all of my various experiences in my career," he said. "We have an opportunity right now to shape the future of health care and make a system that's more affordable and accessible."
Healey also named five other people to the HPC board, including reappointing Chair Deborah Devaux and 1199 SEIU Massachusetts Division senior policy analyst Jamie Willmuth. She newly picked former Codman Square Health Center CEO Sandra Cotterell, Biogen senior vice president Christopher Leibman and former Point32Health -- the parent company of Tufts Health Plan and Harvard Pilgrim Health Care -- Chief Financial Officer Umesh Kurpad.
But the Walsh selection by far generated the most interest.
In the days leading up to Healey's announcement, Beacon Hill was abuzz with speculation about the impending move. Multiple figures with an interest in the health care sector said they reached out to Healey's office before Friday to voice concerns.
Greater Boston Interfaith Organization President Phil Hillman and Rev. Burns Stanfield, the group's prior president, wrote a letter to Healey on Wednesday arguing that existing conflict of interest law "makes it impermissible for Steve Walsh to serve as a[n] HPC Board member while he remains the MHA President."
"We think he's very thoughtful and with great skills, and could even imagine him on the commission someday, but right now, with the position he has, that's a conflict of interest. We want the integrity of that provision respected," Stanfield said in an interview. "It's not about Steve personally. It's just about protecting that wall, that concern around conflict of interest."
Several people interviewed by the News Service said despite Walsh's extensive knowledge and experience, they think his job lobbying on behalf of virtually all hospitals across the state should render him ineligible for a post at the state watchdog agency.
"As a registered lobbyist for the industry, Steve Walsh's appointment is a blatant conflict of interest and problematic to the employer community," said Eileen McAnneny, president of the Employer Coalition on Health. "I hope [the governor] rethinks the decision in light of these concerns."
Walsh said he thinks recusing himself from most matters involving hospital transactions or costs should allay concerns, while leaving plenty of other work to tackle.
"All ideas are on the table" as regulators set out to reduce costs and boost access, he said, including value-based care, AI tools and other technological innovations.
"The Health Policy Commission was created to really change the way our system delivers care, so that it works better for patients and for consumers. Most of what the HPC does is not about transactions between hospitals or relationships between providers and payers or other stakeholders," Walsh said. "It's about how to build a better system that is in desperate need of reform."
In response to the criticism, the Healey administration pointed to Walsh's pledge to recuse himself from any decisions that could represent a conflict.
"Massachusetts is home to the best hospitals in the world. They are at the heart of our health care system. It's essential for someone to bring the perspective and expertise of our hospital system as a commissioner to the HPC," Healey spokesperson Karissa Hand said. "Steve Walsh is uniquely qualified to bring that expertise to the work of the HPC — with his deep understanding of the current challenges facing hospitals, his work with 70 community hospitals across the state, and his experience as a legislator and policymaker."
Walsh has led the industry group representing hospitals since 2017. Before that, he spent six terms in the House, where he co-chaired the Health Care Financing Committee, played a key role in creation of the regulatory agency whose board he is set to join, and developed a strong bond with the Democrat who leads the chamber today.
Walsh was the top House negotiator in 2012 on a landmark cost-containment bill that launched the HPC, and his number-two in those conference committee talks was now-Speaker Ron Mariano. (At the time, then-Speaker Robert DeLeo praised Walsh for the "energy" and "intellectual curiosity" needed to tackle the issue and called Mariano the "Michael Phelps" of health care.)
"At this point in my career, to return to try to perfect it in some way ... is really exciting," Walsh said.
The press release from Healey's office included quotes in support of the six appointees from Lt. Gov. Kim Driscoll and from Mariano.
"The reforms that were made to the structure of the Health Policy Commission last session were designed to ensure that every sector of the health care industry would be represented on the board, a prerequisite for establishing a multifaceted approach to reducing health care cost growth for our residents," the speaker said in a statement provided by Healey's office. "The appointments that are being announced today will help to ensure that industry leaders, across each sector of the Commonwealth's health care system, will have their voices heard, united by the common goal of delivering quality, affordable health care to every Massachusetts resident."
Healey's office did not include any remarks from Senate President Karen Spilka or other Senate Democrats. A Spilka spokesperson declined to comment on the HPC appointments.
New HPC membership faces chronic problems
HPC Board membership as of July 25, 2025
The new and returning board members already have a massive workload in an industry that, as Sen. Cindy Friedman put it in March, is "falling apart."
Many providers have been warning for years about staffing shortages and burnout. Some community leaders worry hospital expansions are crowding out smaller, more affordable local options. Health care costs continue to rise sharply -- up 8.6% from 2022 to 2023, more than twice the 3.6% benchmark that represents the state's goal for reasonable growth -- and regulators have struggled to alter the trajectory of the trend.
Walsh has been an outspoken critic of that benchmarking process.
"The statutorily required discussion that's taking place right here today at this moment is a relic of the past and it no longer serves our patients," he said at a hearing about the cost growth benchmark in March 2024. "Let's work together to create a transformative, sustainable patient-centered system for the future."
For years, the HPC has urged the Legislature to empower it with additional regulatory muscle and teeth so it could more forcefully limit spending growth.
A hospital oversight law Healey signed in 2024 reshaped membership of the board at the HPC, which is responsible for reviewing hospital expansions and mergers, reining in health care-related spending, and tracking key industry trends.
The law newly calls on the governor to appoint one member with "expertise in representing hospitals or hospital health systems" and another member with "expertise in health care innovation, including pharmaceuticals, biotechnology, or medical devices." It also eliminated seats that were previously designated to a primary care physician and a purchaser representing business management positions.
Retailers Association of Massachusetts President Jon Hurst said he's concerned about those underlying changes to the panel's makeup.
"We need to have actual premium-paying and taxpaying advocates on that HPC board, as opposed to the industry, whether it's hospitals or pharma or a union rep being from the health care industry," Hurst said. "It just goes to show that, really, the political bias and priority is toward the industry, the receivers of our premium dollars and our tax dollars, as opposed to the payers."
The board's prior membership expired June 30, and the new makeup took effect July 1. However, the appointments were not made by that point, leaving the board essentially vacant for much of the month -- including on Thursday, when HPC officials initially planned a board meeting that was eventually canceled -- except for two positions automatically held by Cabinet secretaries.
Attorney General Andrea Campbell reappointed Dr. Alecia McGregor and Martin Cohen on Wednesday, according to an HPC spokesperson. Campbell still has one more member to select, a health economist, before the board achieves full membership.