05.02.2016

House budget supports sunset, and more...

House budget supports sunset

The state budget that the Massachusetts House of Representatives passed on Wednesday, after considering more than 1,300 proposed amendments, totals $39.508 billion and contains two key provisions that MHA and hospitals fought for.

One is a “sunset” provision that House Ways & Means committee had included in its draft of the budget. The Baker Administration is seeking $250 million from hospitals to leverage matching federal dollars in order to support the investments in the new MassHealth ACO program and to also reimburse $250 million to hospitals. (However, approximately half of the hospitals in the state will pay more than they receive back in Medicaid payments.) The funding will be part of a five-year Medicaid waiver proposal; the sunset provision would end the collection of the $250 million at the end of the five-year waiver. MHA praised the House Ways & Means committee for establishing the needed provision.

The intent of an important related amendment filed by Rep. Jennifer Benson (D-Lunenburg) was also included in a House Ways & Means perfecting amendment that passed Wednesday; it clarifies that when the sunset provision takes effect, the related transfer of $250 million from the Health Safety Net also ends.

Hospitals also worked hard to ensure the defeat of another amendment that would have increased the hospital burden (and resultant Health Safety Net shortfall) by an additional $50 million. 

Despite strong support, one MHA-backed amendment to prevent controversial Health Safety Net eligibility rules from proceeding and to fund the program with an additional $15 million was not adopted, and another to restore important supplemental payments for disproportionate share hospitals was unsuccessful. MHA will continue its focus on both issues.

Attention turns immediately to the Senate which will engage its budget debate later in May.

MHA introduces new management tool in opioid fight

By all accounts, the widespread opioid crisis requires a multifaceted approach to resolve. Increased control over prescribing, a re-ordering of law enforcement priorities, expanded treatment, and improved public education, among other approaches, are all needed to stop the needless deaths occurring in the state, region, and nation.

Massachusetts hospitals, following the guidance of MHA’s Substance Use Disorder Prevention and Treatment Task Force, are doing their part to limit opioids prescribed through the 51 emergency departments in the state. That guidance was endorsed by the Massachusetts College of Emergency Physicians (MACEP). Now MHA and MACEP are collaborating to introduce a new substance use disorder resource – PreManage ED.

PreManage ED is a collaborative care management tool that gives ED providers real-time information on high-risk patients. In short, ED providers get critical information about a patient quickly, without a time-consuming search for it. They can see that patient’s interaction with other providers, target inappropriate ED use, reduce medically unnecessary ED readmissions, and get other care team members involved quickly to develop a care plan. PreManage ED complements a hospital’s existing electronic health records. 

MHA President Lynn Nicholas, FACHE said, “We’re looking to implement PreManage ED statewide because we know it has been proven to work in other states and because the opioid crisis requires us to use every arrow in our quiver to help hospitals help those at risk in our communities.” 

Conference: how the opioid problem affects business

The Massachusetts Health Council, responding to requests from employers both large and small for practical, timely and focused information on the role of the employer in fighting the opioid crisis, has scheduled a conference on Thursday, June 16 from 8 a.m. to noon, entitled “Our Workplaces and the opioid Epidemic.”  The conference will cover the nature and scope of opioid addiction & what's different about this epidemic; the effect of opioids on business; treatment, recovery, and prevention; managing and supporting employees while keeping the workplace safe and productive; and legal considerations to protect the employer and the employee.  Details about speakers, purchasing tickets (especially for CEOs, HR and benefits professionals, managers, consultants and other interested parties), and sponsorship opportunities is available.  Contact Mass. Health Council Executive Director David Martin for more details: dmartin@mahealthcouncil.org or (617) 965-3711.

Senate approves comprehensive tobacco prevention bill

MHA strongly supports a youth anti-tobacco bill that the Massachusetts Senate approved this past week. Among its provisions, the bill prohibits the sale of tobacco and nicotine-delivery products to anyone under age 21, adds e-cigarettes to the smoke-free workplace law, and prohibits the sale of tobacco in pharmacies and other healthcare facilities.

Commending the Senate, and especially Senate President Stan Rosenberg (D-Amherst), Senator Jason Lewis (D-Winchester) and Senator Harriette Chandler (D-Worcester) for their efforts on the bill, MHA President & CEO Lynn Nicholas, FACHE, said, “Tobacco and nicotine use is the leading cause of preventable illness and premature death in Massachusetts.  It costs the state more than $4 billion annually in healthcare costs.  In addition, tobacco consumption results in hundreds of millions of dollars in lost productivity due to illness and premature death. MHA and our member hospitals and health systems strongly support the collective provisions of this legislation that we believe are essential steps in the effort to eliminate youth tobacco use and addiction and its harmful effects on public health." 

A look at health (and healthy equity) in the U.S. ...

The Centers for Disease Control and Prevention (CDC) has released Health, United States, 2015 – a comprehensive statistical overview of the national health data. The 2015 report contains a special section on racial and ethnic health disparities.

The data is voluminous but a few key points are:

•        Life expectancy for U.S. males is 76.4 years and 81.2 years for females.  The gap in life expectancy between males and females narrowed from 5.1 years in 2004 to 4.8 years in 2014.

•        Between 2004 and 2014, the birth rate among teenagers aged 15–19 fell 40%, from 40.5 to 24.2 live births per 1,000 females—a record low for the United States.

•        In 2011–2014, the prevalence of children with obesity among those aged 2–5 years was 8.9%, 17.5% among children aged 6–11, and 20.5% among adolescents aged 12–19.

•        In 2014, 16.8% of adults aged 18 and over were current cigarette smokers, a decline from 2004 (20.9%). Men (18.8%) were more likely than women (14.8%) to be current cigarette smokers in 2014.

•        In 2014, personal healthcare expenditures in the United States totaled $2.6 trillion—a 5.0% increase from 2013. The per capita personal health care expenditure for the total U.S. population was $8,054 in 2014—up from $7,727 in 2013.

As for racial and ethnic health disparities (which the U.S. HHS defines as: “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage”) the report found:

•        In 2014, life expectancy was longer for Hispanic men and women than for non-Hispanic white or non-Hispanic black men and women.

•        During 1999–2013, infant mortality rates were highest among infants born to non-Hispanic black women

•        In 2014, non-Hispanic black mothers had the highest percentage of preterm births of the five racial and ethnic groups

•        In 2011–2014, non-Hispanic black men and women were the most likely to have hypertension compared with adults in the other racial and ethnic groups. 

... and a special MHA conference on equity of care

Twenty six Massachusetts hospitals have signed the American Hospital Association’s #123forEquity Pledge to Eliminate Health Care Disparities.  By doing so, the hospitals pledge to choose a quality measure to stratify by race, ethnicity or language preference or other sociodemographic variables, and then determine if a healthcare disparity exists in this quality measure. If there is a disparity, the hospitals design a plan to address the gap, provide cultural competency training for all staff. And ensure that the hospital board and leadership address the diversity issue.

On Monday May 16, MHA is bringing together a dynamic group of people from across the U.S. to address the equity of care issue.  DPH Commissioner Monica Bharel, M.D., will be joined by Peggy Harris, FACHE, assistant VP of diversity & inclusion at Carolinas HealthCare System, which developed an action plan for addressing racial and ethnic disparities. Tomas Leon from the AHA will directly address the #123for Equity Pledge and Toni Flowers‐Jefferson and Kinneil Coltman will discuss the varied benefits of a diverse healthcare workforce.

This MHA forum is funded with the support of the HRET and the MA Hospital Engagement Network, and Massachusetts is the first state to hold such a conference under the banner of the #123forEquity pledge. To register, please fill out and return the form below. 

Transition - Baystate Franklin

Cindy L. Russo, MS, RN, FACHE, has been named President/Chief Administrative Officer of  Baystate Franklin Medical Center/Baystate Health Northern Region, effective Tuesday, May 31.  Russo replaces Thomas Higgins, M.D., who has served as interim president since June 2015. 

Russo is currently VP of Operations for Central Region Hartford Healthcare, which includes five acute care hospitals. Previously she served as Hartford Healthcare’s director, clinical services; president/CEO MidState VNA & Hospice; and VP, patient care services/CNO. In 2009 Russo was promoted to SVP, operations at MidState Medical Center, a 144-bed community hospital. 

Russo has a BS in nursing from Western Connecticut State University and an MS in management from the Hartford Graduate Center; she is pursuing a Doctorate in Health Administration at Capella University, Minneapolis.

Effective May 31, Dr. Higgins, who also served as CMO while overseeing Baystate Franklin and the Northern Region, will have his CMO role expanded to include oversight at Baystate Noble Hospital, replacing Dr. Sarah Haessler who has been serving as interim CMO. 

Transition - Baystate Franklin

Nancy Ridley, assistant DPH commissioner from 1994 to 2007, passed away on April 27 at age 71. She began her healthcare career at the then-Lahey Clinic, and worked for 33 years in various healthcare roles for the state.  A constant champion of patient safety, she was a founding member of the Mass. Coalition for the Prevention of Medical Errors and the first director of the Betsy Lehman Center.  She was a member of the Steering Committee for the Mass. Coalition for the Prevention of Medical Errors and a director of the Betsy Lehman Center.  In her roles, she worked closely with many MHA staffers who recall her as a committed and fair public servant dedicated to improving the health of Massachusetts citizens.  Contributions in her name can be made to The Concord Regional VNA and Hospice House in Concord, New Hampshire, or to the Dana Farber Cancer Institute in Boston. 

From silos to systems: healthcare in a post-merger era

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.

John LoDico, Editor