Debate on amendments to the House Ways & Means’ FY17 budget proposal is expected to begin on Monday and MHA and its membership spent the last week advocating on the need to adopt the critical policy matters contained in five hospital-endorsed proposals, and to oppose one proposal that seeks to increase the problematic new $250 million tax on hospitals.

MHA supports Amendment #287, filed by Rep. Jeffrey Sanchez (D-Jamaica Plain), clarifying that hospitals, as a class, shall be paid $250 million in new Medicaid payments related to the new $250 million hospital tax included in the budget.  The current language in the Ways & Means’ proposal states that the amount that hospitals could receive “shall not exceed $250 million.” 

MHA additionally supports Amendment #956, filed by Rep. Jennifer Benson (D-Lunenburg), that seeks to perfect the sunset of the hospital tax by establishing a corresponding sunset for a $250 million funding transfer from the Health Safety Net to the new MassHealth reform trust fund. That is, once the new $250 million tax terminates, then the transfer of the $250 million in tax proceeds must also terminate.  On an important note, a House Ways & Means perfecting amendment (#1293) includes similar language and is strongly supported by MHA.

MHA strongly opposes Amendment #1281, filed by Rep. Frank Moran (D-Lawrence), which increases the hospital tax by an additional $50 million while also increasing the funding shortfall in the Health Safety Net program by $50 million on an annual basis.

MHA and the Affordable Care Today!! Coalition support Amendment #1119, filed by Rep. Christine Barber (D-Somerville), that seeks to protect current eligibility for the Health Safety Net and restore the state’s customary $30 million contribution to the HSN program.

MHA supports Amendment #472, filed by Rep. Aaron Vega (D-Holyoke), to fully restore enhanced Medicaid supplemental payments to disproportionate share hospitals (DSH).

MHA supports Amendment #210, filed by Rep. Kevin Honan (D-Brighton), to ensure that hospitals and community health centers receive the full waiver-allowed amount of $30 million for infrastructure & capacity-building grants (ICB). Governor Baker’s FY2017 budget and the House Ways & Means proposal permit up to $20 million in funding for ICB grants. 

Leadership rounding at the bedside – the process where nurse leaders, administrators, and others talk directly with staff and patients about care and services – is a best practice in most hospitals, yet it comes with many challenges.  It can be time consuming and difficult to standardize.  When rounding is done using a pen and paper, how can care teams compile trend data in the department and across the hospital?  

Emerson Hospital’s care teams wanted to identify a better way to support an excellent patient experience in real time and to track feedback from patients and their families to identify trends. The Emerson team conducted research and discovered CipherHealth’s Orchid rounding tool – an iPad app loaded with best practice questions that supports a structured and real-time approach to rounding at patients’ bedsides.

While nurses regularly check patients’ health and vital signs, nurse leaders are now able to enhance the overall patient experience by obtaining and recording information from patients’ about their entire stay in real time.

“We continually seek opportunities to improve our holistic approach of caring for patients,” said Christine Schuster, president and CEO of Emerson. “When done well, the overall experience patients have at Emerson helps them recover faster and be discharged sooner. Everyone -- our patients and our staff caring for patients -- benefits from the tool.”

Gaining immediate feedback from patients and their families has allowed Emerson’s teams to make a rapid impact and improve the overall experiences of patients, while they are still in the hospital.  In just six months using the tool, Emerson has already seen strong results in positive patient experiences nearly across the board. Its recent HCAHPS score for, “Would you recommend the hospital?” increased nearly three percentage points over last quarter. For “Responsiveness of hospital staff,” its HCAHPS score increased more than four percentage points over last quarter.

Nurse Managers, iPads and Best Practices

In July 2015, Emerson leadership decided to pilot the bedside rounding tool in its medical surgical units. With a grant from the Auxiliary of Emerson Hospital, nurse managers were given iPads loaded with the Orchid tool.  Modeled on those used routinely in the hotel and hospitality industry, the tool has best-practice questions, including  those about cleanliness of the environment, noise, use of care boards, quality of the food, and pain management, among others....

To read the rest of this story, including how Emerson Hospital uses the app to perform rapid service recovery and just-in-time training, visit "Success Stories" at PatientCareLink

CMS’s plan to rate hospitals with stars – similar to how consumers are informed about the quality of restaurants or appliances – has wisely been put on hold by the federal government following concerns raised by the American Hospital Association, other provider groups, 60 U.S. Senators, along with 225 members of the House. CMS said it was delaying the star ratings on its Hospital Compare website from April 21 to at least July. Opposition focused on the fact that to judge if a hospital can provide high-quality care to them for a variety of procedures, consumers should rely on evidenced-based measures and consultations with their primary care providers and families – not on a lump-sum, one-to-four-star  rating.

As noted in previous Monday Reports,  MHA has joined the Massachusetts Coalition for Serious Illness Care. Individual MHA members may join as well. The coalition will be formally launching at a public event on May 12 at the JFK Library with all interested individuals welcome to attend. MHA members are encouraged to send representatives to the event to learn more about the statewide initiative on advance care planning in the commonwealth.

The state’s new law to combat the opioid crisis contains a new requirement – effective April 1 – that hospitals report monthly on all infants and children (under the age of 11) who were treated due to exposure to a controlled substance.  The new process will provide current and critical data to assist providers in developing programs and resources that hopefully will help prevent future opioid addictions among a vulnerable population. MHA will be working with its members to ensure that hospitals are able to effectively implement the new reporting requirements given the short timeframe to comply.

Laura Ames is the new CEO at New England Rehabilitation Hospital in Woburn. She most recently was CEO of Arbour Hospital from July 2013 to April 2016, and before that SVP of Behavioral Health Services at Sisters of Providence Health System. 

FRIDAY, MAY 13; 8:30 A.M. - 2:30 P.M.
MHA CONFERENCE CENTER, BURLINGTON, MASS.

The second in MHA’s series of programs designed to help Massachusetts hospitals and healthcare organizations integrate and “systemize,” this conference will focus on both clinical and operational tactics providers need to succeed in today’s environment. A special keynote speaker – David Brailer, MD, PhD, CEO/managing director of Health Evolution Partners – will speak on where the industry is headed as a result of the Affordable Care Act and its continued aftershocks. There is a lineup of terrific speakers on other topics focused on strategic and clinical operations. Join us as we hear about the many ways that hospitals can scale their services for population health and compete effectively in a challenging environment.