08.07.2017

MassHealth, Minuteman, PatientCareLink, and more ...

MassHealth-to-Commercial Shift on Hold – for Now

Governor Charlie Baker on Wednesday signed off on half of his plan to address growing costs in the state’s healthcare system; he signed a bill that raises the per-worker assessment on employers, but conceded – at least for now – that the legislature would not agree to the second part of his cost-reduction plan that included, among other elements, shifting 140,000 non-disabled people from MassHealth to commercial insurance. The governor previously had argued that the two elements of the plan had to go hand in hand.

That’s not to say that MassHealth reform is dead. Key legislators over the past few weeks said they objected to the governor’s rushed timetable for reforming MassHealth while agreeing that it is an issue that will need to remain under review.

And the governor has said on numerous occasions, including a recent talk with hospital officials, that his plan is not etched in stone; rather, he is open to a dialogue with legislators and stakeholders to manage enrollment growth in MassHealth and reduce state costs.

Baker has argued that the continuing shift of healthy people from their employer coverage to MassHealth, as well as uncertainty on future Medicaid funding from Washington, among other reasons, point to the need of encouraging access to commercial insurance coverage.

Last week, MHA President & CEO Lynn Nicholas, FACHE, said the hospital community could support the governor’s plan to limit non-disabled adults with incomes above 100% of the federal poverty level to eligibility for subsidized insurance in the Connector exchange rather than MassHealth. But only if there are protections for out-of-pocket expenses and for ensuring that enrollees can access coverage readily.  Among other conditions, MHA supports having a plan in place to ensure that if federal funds are reduced, there’s a transparent process to ensure that those affected are able to access coverage.

DoI Named Receiver of Minuteman Health

The state’s Judicial Court on Wednesday appointed the Division of Insurance’s  (DoI) acting commissioner Gary Anderson as the receiver of the health insurance company Minuteman Health “for the purpose of rehabilitating [Minuteman] and conserving its assets.”

Under the court order, providers are prohibited from terminating any agreements with Minuteman and must continue to provide services to the plan’s insured. DoI stressed in its statements that it will be business as usual with respect to the insurance company until DoI submits its court-mandated report and recommendations within 60 days.

DoI says that while Minuteman is currently solvent, its “level of capitalization is very thin.” The insurer has about 37,000 members, of which 74% are in Massachusetts, with the remainder in Massachusetts.

DoI also noted that executives from Minuteman are currently trying to create a new health insurance company by August 16, 2017. “If they are successful, that will afford an additional insurance option for consumers in both states,” DoI wrote.

Check Out the Newly Re-designed PatientCareLink

MHA, in partnership with the Organization of Nurse Leaders of MA, RI, NH & CT (ONL), Home Care Alliance of Massachusetts (HCA), and Hospital Association of Rhode Island (HARI) have launched a newly re-designed and expanded PatientCareLink (PCL) website. In addition to improved usability on multiple platforms and a modern look and feel, the updated PCL website incorporates input from numerous Patient & Family Advisory Councils at hospitals across Massachusetts. 

“We created PCL – then called Patients First – back in 2005 so hospitals and healthcare providers across the commonwealth could clearly post data-driven information about patient safety, healthcare quality, and staffing,” said Lynn Nicholas, FACHE, president & CEO of MHA.
The PCL website gives patients an open and transparent view of the hospitals providing them care. It also features useful tools and information to assist patients and their families to become engaged in their own care.

PatientCareLink also helps healthcare providers improve the work they do on patients’ behalf,” said Pat Noga, RN, PhD, V.P. of clinical affairs at MHA. “Massachusetts hospitals, nurses, physicians, and other caregivers measure themselves each day against the performance data presented through PCL.”

Massachusetts was the first state to voluntarily make hospital staffing and nursing-sensitive quality information public. The site now includes detailed quality and safety measures for Massachusetts hospitals and home care providers, and staffing information for Massachusetts and HARI member hospitals.

PCL also offers detailed information for nurses and other caregivers to advance their professional development, to help maintain their own good health, and to learn best practices on how to improve patient care, said Amanda Oberlies, CEO of ONL.

“The site has information on efforts to address future nursing shortages, expand caregiver education, explore job opportunities, and to incentivize nurses to not only stay in the workforce, but also consider teaching as well,” Oberlies said.

Commission to Trump: Declare Opioid Crisis National Emergency

The president’s Commission on Combating Drug Addiction and the Opioid Crisis last week issued its interim report, stating “our nation is in crisis” and calling on President Trump to declare the issue a national emergency.

Governor Charlie Baker serves on the commission which is chaired by New Jersey Governor Chris Christie.

A major recommendation in the interim report calls on the federal government to grant Medicaid waivers to the Institutes for Mental Diseases (IMD) exclusion within the Medicaid program. As the commission explained, the exclusion “prohibits federal Medicaid funds from reimbursing services provided in an inpatient facility treating ‘mental diseases’ [including substance use disorder] that have more than 16 beds. This exclusion makes states entirely responsible for Medicaid-eligible patients in inpatient treatment facilities, including patients undergoing withdrawal management in addiction treatment facilities rather than hospitals.”

Eliminating the restriction, the commissioners wrote, “is the single fastest way to increase treatment availability across the nation.”
The commission also urged the federal government to mandate that medical education training include courses in proper opioid prescribing. The commission pointed to the Massachusetts experience of adopting this educational practice stance with the assistance of the Mass. Medical Society and the higher education institutions in the state.

The commission’s entire interim report is here.

August is National Immunization Awareness Month

The Centers for Disease Control & Prevention calls immunizations one of the top 10 public health accomplishments of the Twentieth Century. Each week of August will feature a specific theme, relating to infants and children, pregnant women, adults, preteens and teens, with the last week focusing on “back to school immunization issues. Visit DPH’s blog and twitter account throughout the month to see the corresponding information for each week. DPH is also participating in the American Cancer Society National HPV Roundtable “We’re In!” campaign – a national call to action for organizations to show their commitment to HPV vaccination to decrease HPV-related cancers.

Nominations Open for MITSS Award

Medically Induced Trauma Support Services (MITSS) is accepting nominations for its annual Hope Award, presented to anyone who exemplifies MITSS’s mission of supporting healing and restoring hope to patients, families, and clinicians affected by adverse medical events. Nominations are due by Friday, September 15, 2017 by 5 p.m., and the award will be presented at the MITSS 16th Annual Dinner and Fundraiser on Thursday, November 2, at the Sheraton Boston Hotel. Learn more details and access nomination forms here.

The Final 2018 Inpatient PPS Rule

Thursday, August 17; 9 a.m. to Noon
MHA Conference Center, Burlington, Mass.

 

On Wednesday, CMS issued the final FY2018 Inpatient Prospective Payment System (IPPS) rule. MHA’s annual program to review the final IPPS will cover all of the critical changes and updates important to hospitals. Specifically, the program will cover: alternatives to the Two-Midnight Rule, Medicare legislative/regulatory issues, DSH calculations, value-based incentives, and new adjustment factors for hospital-acquired conditions.  And we’ll discuss Worksheet S-10 data and how that will affect uncompensated care payments. Don’t miss this deep dive into an important issue. Learn more and register here.

John LoDico, Editor