Voices in Healthcare

Governor Deval Patrick's proposed 2011 budget assumes another challenging year for Massachusetts and calls for program cuts throughout state government, including MassHealth. The budget maintains eligibility for both MassHealth and Commonwealth Care and assumes both programs will grow in terms of covered lives. While the proposal demonstrates the administration's continued commitment to healthcare reform, hospital reimbursement will again suffer further reductions through the elimination of inpatient acute outlier payments, which cover complex adult patients requiring lengthy hospital stays.

MHA appreciates the governor's recommendations on the Health Safety Net (HSN) that: 1) re-establishes a general fund contribution of $30 million in FY2011 and 2) call for the FY2010 HSN account to receive prior year HSN surpluses to help alleviate an existing $70 million shortfall. However,  the strain on hospital finances remains significant and MHA projects that the FY2011 HSN could experience a shortfall of close to $100 million. Contributing factors to the shortfall include eligibility restrictions on the Commonwealth Care Bridge program for legal immigrants, which force patients to utilize the Health Safety Net, and the elimination of restorative dental care for most MassHealth and Commonwealth Care adults.

The inclusion of new revenues to mitigate the potential depth of possible cuts is important. These revenues include taxes on candy and sugared drinks which are supported by MHA, both for the revenue potential and the contribution to improving public health. In addition, the budget assumes an extension of enhanced Federal Medicaid Assistance Program (FMAP) which is an important priority for Massachusetts and every other state. Even with these important steps, MHA remains deeply concerned about continued and worsening government underfunding of care to patients.

Massachusetts hospitals are committed to working with the state's elected and appointed officials to implement meaningful and sustainable payment reform in the Commonwealth to mitigate increases in healthcare costs. But true reform will still require hospitals to be adequately paid for care provided to our most vulnerable residents. Short-changing providers through government reimbursements that are
substantially below costs only exacerbates these problems, rather than ease them, and potentially threatens the ability of hospitals to pursue their critical care-giving missions.

The Governor's support for sustaining health care reform is clear. While the economic downturn has stalled the Commonwealth's commitment to close the Medicaid payment gap, the state must pursue the full funding of care provided to our most vulnerable populations.  This would demonstrate the same "shared responsibility" that was shown by providers, employers, and insurers when the Commonwealth tackled coverage reform in 2006. MHA and its member hospitals pledge to continue to work with our fellow healthcare leaders throughout Commonwealth to achieve an appropriate balance of revenue and cost containment.