Two of the most prominent medical centers serving children in Massachusetts are moving in opposite directions.

Boston Children’s Hospital, Greater Boston’s biggest pediatric health care provider, is expanding, while Tufts Medical Center in Boston is closing inpatient services for children.

The changes reflect an ongoing trend of big hospital systems becoming more powerful while smaller competitors sometimes struggle to keep services open.

Boston Children’s is opening an 11-story addition with 150 new beds and more than a dozen high-tech operating rooms. The first patients arrive Tuesday.

The hospital says its new Hale Family Building will allow it to keep up with the demand from families of children who need care for complex medical conditions and sometimes face long waits for treatment.

The NICU in the Hale Family Building at Boston Children’s Hospital. (Jesse Costa/WBUR)
The NICU in the Hale Family Building at Boston Children’s Hospital. (Jesse Costa/WBUR)

“This is such a milestone for us,” said Patty Hickey, associate chief nurse for cardiovascular, critical care, and perioperative services for Boston Children’s. Before the expansion, the hospital often delayed and canceled surgeries because of a lack of space, she said.

The $1 billion expansion comes after years of planning and controversy. When it was first proposed, a group of opponents tried to block the project because it would replace the Prouty Garden, a beloved green space where sick children and their families found comfort during long hospital stays.

Those attempts failed, and state officials approved the project in 2016.

About half of the new building is for children with heart problems, including babies born with congenital heart disease who need surgery in their first days of life. Boston Children’s has become a magnet for these patients from all over the country and the world, said Dr. Tal Geva, chief of cardiology at the hospital.

In many situations, he said, the team of local doctors has done everything they can. But Boston’s Children’s still offers the families hope. “They come here.”

Boston Children’s Hospital staff prepare to conduct a gene therapy simulation in the Hale Family Building. (Jesse Costa/WBUR)
Boston Children’s Hospital staff prepare to conduct a gene therapy simulation in the Hale Family Building. (Jesse Costa/WBUR)

With more operating rooms, doctors expect they’ll be able to treat more children more quickly.

“For some patients, the sooner you can get them into surgery, the better it will be in terms of their long-term outcome,” said Dr. Francis Fynn-Thompson, a cardiac surgeon. Fynn-Thompson said the expansion could also be a huge relief for families, who have struggled with the long wait times, knowing their children need surgery.

One of the new operating rooms includes an MRI machine that can help surgeons pinpoint brain tumors during an operation.

The building also includes a bigger intensive care unit for newborns, giving families more privacy with their babies and care providers more space to treat the little patients.

After Boston Children’s completes other renovations, including converting double rooms to singles, it will gain 71 beds for a total of 475.

Meanwhile, a few miles across Boston, Tufts Medical Center is shutting down inpatient services for children by the end of June. Tufts leaders say they don’t have enough patients to keep running pediatric beds — and they’re referring patients to Boston Children’s instead.

The decision triggered an outcry from doctors, nurses and patients when it was first announced in January. State officials required Tufts to submit a plan to make sure patients will continue to have access to medical services, but they had no power to stop the closure.

Tufts Medical Center is shutting down inpatient care for children this summer. (Robin Lubbock/WBUR)
Tufts Medical Center is shutting down inpatient care for children this summer. (Robin Lubbock/WBUR)

This means less choice and potentially higher out-of-pocket costs for families. Boston Children’s is the most expensive academic medical center in Massachusetts, according to state data, and insurance plans often charge higher co-pays and deductibles for pricier hospitals.

Boston Children’s spokesman Jamie Kelly said the hospital is committed to controlling health care spending. The state requires all health care providers and insurers to limit spending growth to 3.6% a year.

Kelly said about 70 doctors from Tufts and most of the hospital’s pediatric patients are transitioning to Boston Children’s. “We are working actively with Tufts to recruit additional physicians to support our clinical collaboration,” he said in an email.

Massachusetts General Hospital and Boston Medical Center also have hospital beds for children, though Boston Children’s is much bigger. It is also the top-ranked pediatric hospital in the country by U.S. News & World Report.

Outside the Longwood Medical Area, Boston Children’s is planning a $435 million expansion into suburbs north, south and west of Boston — including a new outpatient surgery center in Needham. It’s also working to acquire Franciscan Children’s in Brighton, a provider that specializes in mental health and long-term rehabilitation for children.

David E. Williams, president of the Boston consulting firm Health Business Group, says the expansion of Boston Children’s is likely to help young patients access care they need. But he said regulators need to pay attention as the hospital continues to grow.

“They don’t really have much competition,” he said. “And any organization that doesn’t have competition needs extra oversight.”

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