Health Safety Net Changes Would Affect Patients

Executive Office of Health and Human Services (EOHHS) has issued a series of proposed rule changes that would affect who is eligible for services from the Health Safety Net as well as the coverage period for new patients. The Health Safety Net helps to finance care provided to Massachusetts low-income residents who are uninsured or underinsured.

The governor’s FY2017 budget proposal eliminates the $30 million contribution to the Health Safety Net. The Baker Administration states the new proposed rules, if enacted, would reduce HSN expenses, which justifies the elimination of the state’s $30 million annual contribution to the safety net.  However if the state backs out of its HSN commitment, hospitals would be entirely responsible for the reduced funding. Every acute hospital now pays an assessment which totals $165 million in the aggregate for all hospitals. Insurers pay a similar amount. Hospitals alone, however, are responsible for funding any HSN shortfall. The current shortfall is estimated at $76 million.

One specific proposed change to the HSN eligibility rules includes altering the retroactive date of coverage. Currently, many patients who get coverage under the HSN are covered for six months retroactive from their application. EOHHS proposes changing that to only 10 days retroactive coverage.

The concern among hospitals caring for the uninsured and underinsured is that patients don’t always apply for or complete their application for HSN coverage at the time they receive care. There is often a lag between the time of care, the receipt of a hospital bill, the patient’s realization they need coverage, the hospital enrollment staff’s ability to contact the patients in a timely manner, and completion of the application process. When retroactive coverage is reduced as in the case of new 10-day proposal, hospitals and community health centers are more directly exposed to the cost of care for uninsured patients who do not apply at the time they receive care. In those cases providers, effectively, eat the cost of care and aren’t reimbursed.

Among other proposed changes, the Baker Administration wants to change the income eligibility standards for those eligible for HSN care. For example, currently those earning between 200% and 400% of the federal poverty level (FPL) are eligible for partial HSN coverage. The Baker Administration wants to change that to those with incomes between 150% and 300%. The proposed regulation also creates a new minimum deductible for some HSN enrollees.

The administration states these changes are designed to align with other eligibility standards for MassHealth and Connector. The policy changes are estimated to be worth $60 million annually, much of which will result in a direct cost-shift to hospitals. If enacted, the new proposed rules would be effective April 1, 2016.

EOHHS will hold a public hearing on Friday, February 26 at 9 a.m. on the proposed changes to the eligibility rules. MHA will be offering testimony. 

MHA’s Opioid Efforts Featured In National Webinar

An MHA-backed effort through which all Massachusetts hospital emergency departments have agreed to work toward implementing new opioid prescribing guidelines has been termed by the American Hospital Association (AHA) “one of the nation’s most comprehensive and groundbreaking efforts to combat the opioid crisis.”

The work of MHA’s Substance Use Disorder Prevention and Treatment Task Force (SUDPTTF) will be featured in a nationwide webcast on Tuesday, March 8 from noon to 1 p.m.  The webinar entitled “Combatting the Opioid Crisis: Massachusetts’ Path to Action” is part of AHA’s Hospitals in Pursuit of Excellence series.

In July 2014, MHA received guidance from its Board of Trustees to create a high-level task force to create definitive actions/interventions that hospitals could adopt to curb the opioid abuse. In relatively short time, in February 2015, MHA’s SUDPTTF, comprised of 28 experts from across the state, issued comprehensive Emergency Department Opioid Management Guidelines that: standardize opioid prescribing practices, provide guidance on screening patients seeking opioid prescriptions, offer information on appropriate pain management and treatment, and help identify resources for patients needing substance use treatment. Currently, 100% of MHA member hospital CEOs along with their Emergency Department chiefs (or equivalent authority) have signed commitment letters to work toward implementing the guidelines. Also, some of the MHA Task Force recommendations have been incorporated into sweeping opioid legislation that is expected to be enacted in Massachusetts this year. In addition, five other states across the U.S. have contacted MHA to learn more about the steps they can take to emulate the innovative opioid management practices created by the Task Force. That Task Force is currently working on Phase Two of its recommendations which will recommend operational and individual provider best practices for opioid use throughout the hospital setting.

The March 8 AHA webinar will feature Peter J. Holden, president  and CEO of Beth Israel Deaconess Hospital-Plymouth and MHA Board Chair, who initiated the board’s action on opioids; MHA’s VP of Clinical Affairs Patricia Noga, RN, who co-chairs the MHA Task Force along with Holden; and MHA VP of Clinical Integration Steven M. Defossez, MD. The webinar is free of charge.

Obama Proposes More Funding For Opioid Fight

President Obama, noting that nearly 29,000 people in 2014 died from opioids, announced on Tuesday that he was seeking an additional $1.1 billion from Congress to fight the problem.

His proposal to be included in his FY2017 budget devotes $920 million to support cooperative agreements with states to expand access to medication-assisted treatment for opioid use disorders. According to the White House, “States will receive funds based on the severity of the epidemic and on the strength of their strategy to respond to it. States can use these funds to expand treatment capacity and make services more affordable.” Another $50 million would go to National Health Service Corps to expand access to substance use treatment providers, and $30 million would go to “evaluate the effectiveness of treatment programs employing medication-assisted treatment under real-world conditions and help identify opportunities to improve treatment for patients with opioid use disorders.” Additional money would expand “state-level prescription drug overdose prevention strategies, increase the availability of medication-assisted treatment programs, improve access to the overdose-reversal drug naloxone, and support targeted enforcement activities.”

As there are similar bills in Congress, including Republican-backed proposals, the possibility of some sort of opioid-fighting legislation actually becoming law in the contentious D.C. environment is real.

Nominations For Schwartz Center Award Now Open

Nominations for the Schwartz Center’s 2016 National Compassionate Caregiver of the Year Award are now open.

The annual award recognizes healthcare professionals from across the country who exemplify extraordinary devotion and compassion in caring for patients and families and who make a difference through their unmatched dedication to compassionate, collaborative care.

The Schwartz Center is accepting nominations for the 2016 National Compassionate Caregiver of the Year Award until March 31, 2016. Individuals and teams that work in any U.S. healthcare setting and have direct patient contact are eligible. Nominees may include physicians, nurses, therapists, social workers, psychologists, nurse practitioners, physician assistants, certified nursing assistants, home health aides, and chaplains – as well as interdisciplinary teams of caregivers. Nominations may be submitted by patients, family members, or colleagues who work with the nominee. Nominations can be submitted here.A national review committee will select six finalists from nominations, and from those one will receive the prestigious award. The recipient will be announced at the Annual Kenneth B. Schwartz Compassionate Healthcare Dinner on Tuesday, November 15, 2016 in Boston.  

Transmission Of Zika Virus

Would You Recommend Your M.D. To A Friend?

Massachusetts Health Quality Partners (MHQP) on Tuesday released results of its statewide patient experience survey, which encompasses 65,000 patients from more than 500 primary care practices representing nearly 4,000 doctors. The survey contains a number of questions about the care provided to patients along with one key inquiry: Would you recommend your doctor to your family and friends?

Results are at healthcarecompassma.org.

MHQP notes that questions about whether or not providers ask patients about feeling depressed, feeling stressed, or experiencing problems with alcohol, drugs, or a mental or emotional illness were reported for the first time in its 2014 survey results. The 2014 statewide behavioral health mean score of 53.1 indicated that there was substantial room for improvement. The results of the 2015 survey indicate improvement to 56.5, with several practices having made “truly noteworthy progress,” according to MHQP.

The survey found that primary care physicians across the state excel in communicating with their patients. The communication mean score for all practices across the state is 93.5 out of a potential 100 points. Other areas with strong statewide mean scores include integration of care, knowledge of patient and office staff interaction.

Project Management For Healthcare

FRIDAY, MARCH 18; 8:30 A.M. - 3 P.M.
MHA CONFERENCE CENTER, BURLINGTON, MASS.

The fundamental purpose of project management is to be one step ahead of potential risk that could show itself during your project planning and execution. The trick is to plan, organize, and control as many of the steps as possible to mitigate unnecessary consequences. This seminar is designed to do just that. It will provide you with strategies that you can use right now, wherever you are in your project timeline. Whether it’s starting the project plan or building the right team for the task, key strategies on time management, effective communication, and maintaining motivation will be presented. A “how to” related to workflow diagrams will be a significant takeaway as it’s the ultimate preparation tool to identify where current process breakdowns are occurring and to highlight areas that require more attention before implementation begins. During implementation, decision making and leadership essentials become indispensable in order to keep the project on track and on time. Finally, knowing how to manage and measure change becomes the proof of the project’s success. Key tactics covering these critical topics and more will all be addressed in this one-day program.