Massachusetts has rolled out an interim draft of a COVID-19 vaccination plan, detailing among other things the phased approach to distributing the vaccine if and when one becomes available.
  
According to the state plan as well as initial guidance from the federal CDC, Massachusetts expects to receive the vaccine in three phases. The first limited phases of doses will be allotted to healthcare personnel likely to be exposed to people with COVID-19; people at increased risk for severe illness from COVID-19, including those with underlying medical conditions and people 65 years of age and older; and other essential workers.
  
The vaccination plan states that the state “knows that this initial allocation of vaccine will be insufficient to immunize all providers associated with healthcare institutions and long-term care facilities. Within each participating facility prioritized by [Mass. DPH], prior identification of clinical providers and non-clinical staff with anticipated direct contact with COVID-19 patients, patients over 65, and those with specific co-morbid conditions will be identified and flagged for prioritized vaccine allocation. Strict allocation management by facility and specificity of eligible recipients at the facility level will be required to ensure complete and equitable distribution of vaccine in this initial phase.”
  
The plan then details wider distribution of the vaccine in future phases, with reliance on a broad network of vaccine providers including hospitals, community health centers, and others.
  
MHA has created its own vaccine advisory group to assist facilities with the downstream issues of storage, distribution and other items once the vaccine flows into and through the state. That MHA group will work closely with the state vaccine planning group on the complex undertaking.
  
MHA President & CEO Steve Walsh said, ““We appreciate the hard work of state and clinical leaders that went into this draft plan, which provides the commonwealth with an important roadmap for the effective distribution of a COVID-19 vaccine. We look forward to working with the Baker Administration and its Vaccine Advisory Group to ensure our hospitals are a central part of the safe and equitable rollout of an eventual vaccine.”
  

Continuing its nationally recognized effort to curb physician and clinician burnout, a joint Massachusetts Medical Society (MMS)—Massachusetts Health & Hospital Association (MHA) task force on the issue is asking each Massachusetts hospital and physician organization to sign a letter demonstrating their facility’s commitment to effectively addressing burnout.
  
Specifically, the MMS-MHA Joint Task Force on Physician Burnout is asking each facility to select a measure of physician/clinician burnout and measure it over time, and include improving that particular metric of burnout within the facility’s institutional goals.
  
A facility can choose its own measure from among the many evidence-based ones currently available, such as those listed here. Alternatively, a facility can construct its own measure. For instance, one physician practice has dramatically reduced the number of “clicks” a physician must make when coordinating a patient’s care with the facility’s electronic health record system. There is broad consensus that a major contributor to physician burnout is dissatisfaction and frustration with EHRs. The 2018 Physician Survey identified EHRs as the single most important “pain point” physicians faced in their practice. For many physicians, the patient encounter is now dominated by the demands of the EHR, undermining the crucial face-to-face interaction that is at the core of quality care. 
  
Other anti-burnout strategies include appointing a chief wellness officer at institutions, and providing clinicians with counseling and mental healthcare without stigma and without unnecessary constraints on a physician’s ability to practice.
  
The MMS-MHA Joint Task Force on Physician Burnout produced a landmark report on the issue in 2018 and has collaborated over the past two and a half years with state and national groups, including the Harvard T.H. Chan School of Public Health, the Harvard Global Health Institute, and the National Academy of Medicine. During the pandemic, the burnout issue among caregivers has only increased and providers have been proactive about finding new and creative ways to support their workers’ wellbeing. 
  

Massachusetts hospitals will be playing an important role in assisting people who may be facing evictions from their homes now that a temporary state moratorium on evictions has been lifted.
  
When COVID-19 hit and the economy staggered, many people who lost their jobs faced evictions from their homes due to their inability to pay their rent. In the midst of the surge, the state issued a helpful eviction moratorium, but that expired on October 17. When the state moratorium expired, a federal moratorium established by the Centers for Disease Control and Prevention (CDC) became effective in Massachusetts. Through December, the CDC moratorium will prevent evictions for non-payment for qualified tenants who submit a written declaration to their landlord.
  
Now, the state has reached out to hospitals and other providers for help in reaching households – before an eviction takes place – so the state can provide appropriate funding and mediation tools for landlord-tenant disputes. The state launched a new website that connects residents to their local Housing Consumer Education Center, answers frequently asked questions, and more. Hospitals will be sharing that information – including pamphlets in numerous languages – throughout their service areas. Massachusetts hospitals through their existing community benefits programs already undertake many initiatives focusing on how quality housing can affect an individual’s healthcare. 
  

There was some good news on the federal COVID-19 relief front last week. Providers that have received funding from the federal government through the various relief bills were required to report how the funding was used and were limited as to what the funding could be used for. One measure the Health Resources and Services Administration put in place in September limited the ability of providers to use the federal grants to cover lost revenue, despite the fact that this was a primary purpose of Congress appropriating relief funding. 
 
Following nationwide objections, including those from MHA, the American Hospital Association, and a large contingent of Members of Congress, including Rep. Richard Neal and others from the Massachusetts delegation, U.S. Health & Human Services (HHS) last week reversed the lost revenue reporting requirement policy. It instead instituted a reporting measure that recognizes the actual revenue losses that resulted from the historic decline in patient services delivered, including those losses due to emergency actions that required hospitals to cease elective procedures for a period of time.
  
The change is an important clarification that helps to better ensure Provider Relief Funding can be used as Congress intended: to support healthcare providers that experienced a significant reduction in revenues during the public health emergency. While this change is very helpful, HHS still is not permitting providers to determine lost revenues based on a comparison of budgeted to actual revenues, continuing to limit the methodology to a year-over-year change. 
 

Everyone is keeping a close eye on the various metrics relating to COVID-19 cases in the commonwealth and across the country.
  
The following numbers, in particular, are raising concern amongst healthcare providers: 
• The recent uptick in new confirmed cases (for example, 1,128 on Saturday, Oct. 24) 
• Percent of tested individuals who are positive (5% on Oct. 22, compared to 2.3% a month ago)
• COVID-19 hospitalizations, which last week were up 54% since Labor Day.

Healthcare organizations, along with state leaders and public health authorities, continue to urge the public to remain vigilant and continue taking the basic steps: wear a mask, practice strict social distancing, avoid large crowds, and get a flu shot.

MassEcon, the private sector economic development group, has awarded one of its Team Massachusetts Economic Impact Awards to the Massachusetts Life Sciences Emergency Supply Hub of Cambridge. In March MHA partnered with the Massachusetts Biotechnology Council, Massachusetts Medical Device Industry Council, and Conference of Boston Teaching Hospitals to form the Supply Hub, which solicits donations from life sciences organizations, including lab, testing, and diagnostics supplies; personal protection equipment (PPE); and medical and scientific expertise. To date, more than 500 companies and many private citizens have answered the call and MHA has been able to facilitate the direct donation of N95 and KN95 masks, safety goggles, gowns, and hand sanitizer to hospitals in need, primarily those designated as safety net hospitals. Many more supplies were directed to MEMA as part of their efforts to bring supplies to healthcare facilities. Read about other MassEcon “corporate heroes” here.

James W. Hunt, Jr., president and CEO of the Massachusetts League of Community Health Centers for 41 years, announced last week that he is retiring in December. Hunt helped found the League in 1972. Michael Curry, the League’s current deputy CEO and general counsel, will succeed him.
  
Hunt has been an important healthcare leader in the state and nationally, helping to redefine the role of health centers, expanding their reach into communities, and standing at the forefront of a multitude of issues that have improve healthcare for the residents of the Massachusetts. 

Roundtable Discussion: Population Health and Data Reporting Strategies in the Era of COVID-19

Thursday, October 29; 2-3 p.m.

 

In the wake of COVID-19, Massachusetts hospital reporting processes underwent a massive transformation as health systems raced to move from retrospective to real-time reporting of key metrics such as bed availability, PPE burn rate, and inventory of nasal swabs, reagents, ventilators, and medications. These insights were critical to public health administrators working to coordinate a statewide response to the pandemic. As federal reporting requirements change and case counts across the state begin to climb – and with the possibility of another surge – it it is critical that hospital and public health leaders consider additional reporting strategies that will better prepare the healthcare system. Join us for a one-hour panel discussion convened by the Massachusetts Health & Hospital Association and Dimensional Insight, moderated by Jeff Becker, Senior Healthcare Analyst, Forrester. Learn more and register by clicking here.