The US Senate on Thursday released their version of the American Health Care Act (AHCA), which passed the House on May 5th.  Like the proposal that passed in the House, the Senate bill seeks to repeal significant portions of the Affordable Care Act, including a phase out of Medicaid expansion and a per-capita cap to replace federal Medicaid matching.

“The draft bill to repeal the Affordable Care Act released today by the U.S. Senate’s GOP majority does absolutely nothing to assuage the concerns of Massachusetts hospitals, health systems and other providers about the damage such legislation would do to our state and national healthcare systems and most of all to patients,” said MHA President & CEO Lynn Nicholas, FACHE. “While the ACA wasn’t perfect, I challenge any Republican Senator to name one thing in this bill that will make healthcare in the US better for patients or the healthcare professionals who care for them. In fact, the Senate proposal will make all involved worse off compared to the benefits offered by the Affordable Care Act.”

A budget analysis by the Congressional Budget Office (CBO) is due by Monday, June 26, and Senate Majority Leader Mitch McConnell (R-KY) announced plans to schedule a vote next week.  

Even without a CBO score, it’s clear this bill would still reduce access to affordable coverage for low and middle income families, increase medical debt and out-of-pocket costs for patients, exacerbate cost-shifting to employer insurance and increase the amount of uncompensated care hospitals and other providers would face as the number of uninsured individuals increases.

“If the House Affordable Health Care Act was a ‘mean’ bill, the Senate version is a ‘nasty’ one,” Nicholas added. “We are fortunate to have our entire congressional delegation working to defeat this repeal effort and a governor working in concert with them to minimize the harm posed to our state.”

Following legislative review by the recently created Joint Committee on Marijuana Policy, the House and Senate last week approved differing bills that amend the state’s new law legalizing the commercial sale of marijuana. The bills will now move to a House-Senate conference committee to reconcile differences between the two proposals.
 
The House proposal included a number of changes to the law that would enhance public health protection and are strongly supported by MHA. These include independent testing standards for the safety of products; labeling requirements including an explicit public health warning; opaque and child-proof packaging; potency or dosing limitations on the serving size for marijuana products; an increased excise tax; and dedication of funding to substance use disorder prevention and treatment. 

The Senate bill also included independent testing standards, and a robust research agenda to understand the long-term impacts public health impacts of the legalization of commercial marijuana. During the Senate debate, additional amendments supported by MHA were adopted, including enhanced packaging and labeling requirements; earmarked funding to support substance use prevention and early intervention for children through schools and local community coalitions; and strict prohibitions on advertising of marijuana products directed at children.   

“Throughout the debate leading up to the ballot question and subsequent consideration of legislative improvements, MHA and its member hospitals have advocated for the enactment of steps to preserve and protect public health in Massachusetts – with a particular focus on preventing harm to children,” MHA President & CEO Lynn Nicholas, FACHE said.

MHA will be analyzing the changes made to both bills during debate that went late into the evening on both Wednesday and Thursday and will make recommendations to the conference committee on the public health priorities that should be included in a final bill that is anticipated to go to Governor Baker’s desk by a self-imposed July 1 deadline.

MHA hosted an educational webinar Wednesday for the new Pain Stewardship Program (PSP) it announced with Mallinckrodt Pharmaceuticals. The new PSP for healthcare providers and clinical staff was developed in collaboration with a multidisciplinary team of expert advisors including representatives from MHA’s Substance Use Disorder Prevention and Treatment Task Force (SUDPTTF), led by Beth Israel Deaconess Hospital Plymouth’s John M. Connolly MD, Chairman of the Department of Anesthesia and VPMM, and James A Berghelli, R.Ph, MS, Director of Clinical Integration.

The PSP is intended to educate hospital stakeholders on multimodal analgesia (MMA)-based acute pain management to support improvements in in-hospital opioid use, length of stay (LOS) and satisfaction with treatment. The program provides evidence-based, educational pain management tools to help assess current hospital protocols and identify areas for improvement.

“Massachusetts hospitals and clinicians have made significant improvements in reducing overall opioid usage as well as educating our patients on associated risk factors and proper disposal of opioids. Our providers are also committed to developing alternative pain management practices that improve patient satisfaction, safety and outcomes,” said Patricia M. Noga, PhD, RN, MHA’s Vice President of Clinical Affairs and the Chair of the MHA SUDPTTF. “The Pain Stewardship Program emphasizes non-opioid analgesics and techniques as first-line therapy that is a balanced acute pain management practice, which we believe will assist in addressing the opioid crisis impacting our communities.”

Resources and tools will be available via www.PainStewardship.com, and MHA’s SUDPTTF webpages to help institutions build internal consensus, implement recommendations, educate surgical patients and assess both patient acute pain and clinical risk factors.

MHA – joining with the Massachusetts Health Council, the Boston Foundation and the American Heart / American Stroke Association – testified Tuesday before the Joint Committee on Revenue in strong support of a tiered excise tax proposal on sugary drinks. SB1562/HB3329, filed by Sen. Jason Lewis (D-Winchester) and Rep. Kay Khan (D-Newton) recommends three tiers: drinks with little or no added sugars will not be taxed at all; drinks with moderate amounts of added sugars will be subject to a one-cent-per-ounce tax rate; and drinks with 20 grams or more of sugar per 12 ounces would be taxed at two cents per ounce. The proposal does not ban sugary drinks; people can buy as much as they want. But it encourages the beverage industry to reformulate their products and avoid taxation by reducing the sugar content in their beverages. 

“The statistical evidence is clear that the rate of type 2 diabetes among the youth of our country is rising due to more overweight children,” said MHA’s President & CEO Lynn Nicholas, FACHE, who before coming to MHA was president of the American Diabetes Association. “Sugary drinks, unlike junk foods which may contribute some nutrition to the diet, are just ‘empty’ calories. Drinking just one sugary drink a day increases a man’s risk of having a heart attack or dying from a heart attack by 20%. So taking the initial steps to improve public health by dissuading the consumption of beverages with proven harm and little nutritional value should be a no-brainer.”

It has been estimated that the tiered tax could raise $360 million annually, the monies of which would go towards prevention and well ness programs, DPH’s “Mass in Motion” program, nutrition programs, and municipal grants to improve water quality and water access.

The Division of Insurance (DOI) has scheduled two webinars to assist carriers and providers to understand the Risk-Bearing Provider Organization (RBPO) certificate process in relation to the development of MassHealth ACO contracts.  During these webinars, DOI representatives will discuss which entities currently have Risk Certificates, whether related but different provider organizations may need to obtain a new RBPO certificate, and a recap of both the filing and DOI review processes for applications.

Please note that both webinars will cover the same material, and participants can choose which to join based on their own schedules. 
The webinars will take place on:
• Thursday, June 29, 2017 from 1-2 p.m.
• Thursday, July 6, 2017 from 1-2 p.m.

For more information on how to join the webinar, please contact Niels Puetthoff at niels.puetthoff@state.ma.us or (617) 521-7326. In addition, please dial 1-877-820-7831 and enter Participant Code 627192 in order to join the call that will be part of both webinars.

The Massachusetts Health & Hospital Association is leading the charge to make sure that our commonwealth’s healthcare leaders are ready for what’s ahead. Our Women’s Conference specifically focuses on the industry’s female healthcare leaders – not only in the C-suite, but at every level of the organization. This year’s featured speakers include Nancy Schlicting, Retired CEO, Henry Ford Health System &  Author of Unconventional Leadership: What Henry Ford and Detroit Taught me About Reinvention and Diversity, and workplace communication expert Skip Weisman. Learn more and register here.