As the Massachusetts House and Senate begin to construct their FY2020 budget proposals, MHA, in consultation with its members, is calling attention to a series of priorities, including ongoing concerns related to the MassHealth program, and funding for the Health Safety Net Trust Fund and disproportionate share hospitals.

In recent years, MassHealth reimbursements have been held flat or have declined, most notably for outpatient services and outlier payments for the unexpectedly high cost of providing care to the most complex, highest-need MassHealth patients.  Additionally, the statutorily required yearly transfer of state funds to the Health Safety Net (HSN) Trust Fund has not been made since FY15.  Assessments on acute care hospitals, ambulatory service providers, and surcharge payers (insurers and large employers), fund the HSN. However, hospitals are financially responsible for any funding shortfall in the program. Due to continued shortfalls, MHA has requested that the state increase – and guarantee – its commitment to the HSN.

“Extraordinary care provided to the most complex patients carries with it the need for extraordinary support,” MHA President & CEO Steve Walsh wrote to Rep. Aaron Michlewitz (D-Boston), the chairman of the House Ways & Means Committee, and Sen. Michael Rodrigues (D-Westport), chairman of Senate Ways & Means.

MHA is also seeking a 2% increase to reimbursement rates paid to disproportionate share hospitals (DSH) as well as a supplemental payment for DSH providers that offer significant behavioral health services; and an inflation update to rates paid to chronic disease and rehabilitation hospitals. (The governor’s proposed budget released in January contains no such updates.) Walsh’s letter also seeks language changes to new MassHealth telemedicince coverage options to ensure that all MassHealth members, including those in the fee-for-service plans, have access to behavioral health services where a distant provider is located in a hospital outpatient department.

In his letter to Michlewitz and Rodrigues, Walsh wrote that collaborative relationship between hospitals and the legislature “is not only important in addressing hospital-specific issues, but also in advancing our shared goals of maintaining affordable healthcare coverage, adequately supporting those who provide care, improving the delivery of healthcare, and aligning the healthcare finance system to better support delivery systems and coverage reforms.”

Last week, MHA submitted testimony strongly supporting a bill (HB 140) filed by Rep. Kay Khan (D-Newton) that would prohibit any licensed medical, mental health, or human service professional from engaging with a minor in so-called conversion therapy – that is, attempting to change a minor’s sexual orientation or sincerely held conviction about gender.

Fifteen states already ban such “change efforts,” which are condemned by leading professional organizations including the American Academy of Pediatrics and the American Medical Association.

The Joint Committee on Children, Families and Persons with Disabilities, chaired by Khan and Sen. Sonia Chang-Diaz (D-Boston), held a hearing on Khan’s bill last Tuesday, and voted to give it a favorable report.

In offering its support for the conversion prohibition, MHA wrote, “State-licensed professionals are expected to provide support and appropriate treatment to their clients, while abiding by Hippocratic maxim of, ‘Do no harm.’ When it comes to children, such professionals strive to assist their clients with learning to accept themselves for who they are and to develop effective coping skills to relieve emotional suffering through various forms of therapeutic treatment.”

On Thursday, Governor Charlie Baker indicated that “if a conversion therapy bill gets to my desk and we don't see any other issues with it, it's something we'd be inclined to support.”

This week, March 10 through 16 is Patient Safety Awareness Week. Patient safety takes many forms but in the healthcare field, it’s defined as reducing harm. In just the past few months, Massachusetts hospitals have improved safety by instituting best practices, compiled by an expert panel, relating to care provided to patients with Alzheimer’s and related dementias. Hospitals are embracing “caring for the caregiver” strategies to show gratitude to workers while protecting their safety and wellbeing, as having a healthy and grounded workforce improves patient safety. Massachusetts hospitals are proud of their tireless efforts to help end the scourge of opioids. An expert panel that MHA assembled developed guidelines to assist acute care hospitals in implementing a Medication for Addiction Treatment (MAT) program in their emergency departments or satellite emergency facilities. MHA, in collaboration with the Massachusetts College of Emergency Physicians, developed guidelines on Substance Use Disorder Evaluations. And right now, separate groups of Massachusetts hospitals are working to address specific patient safety areas in a coordinated effort to reduce harm, readmissions, and infections.

A proven, important tool in treating those with opioid use disorder is to provide them with buprenorphine. But to obtain a waiver to prescribe it, physicians are required by federal law to have eight hours of training, while nurse practitioners and physician assistants must complete 24 hours of training.

Boston Medical Center’s (BMC's) Office Based Addiction Treatment Training and Technical Assistance (OBAT TTA) program, sponsored by BMC’s Grayken Center for Addiction and DPH’s Bureau of Substance Addiction Services, in coordination with the American Academy of Addiction Psychiatry, are holding four separate buprenorphine waiver trainings in March and April. The trainings for physicians, nurse practitioners, and physician assistants will focus on the science of addiction, the pharmacology of buprenorphine, regulatory requirements around prescribing it, screening patients, and more. The course fulfills 8 hours of the training needed.

The following course is geared towards ED providers, although all providers are welcome: 
 
• Saturday, March 23, 8:30 a.m. to 4:30 p.m. – Berkshire Plaza Hotel, Pittsfield. To register, click here.

The OBAT TTA team at BMC will hold these three separate buprenorphine waiver trainings at the hospital: 
 
• Thursday, April 4, 8:30 a.m.-4:30 p.m. – Click here for information and to register. 
• Tuesday, April 23, 1 to 9 p.m. – Click here for information and to register. 
• Monday, April 29 8:30 a.m. 12:30 p.m. – Half & Half waiver training (4 hours in person, 4 hours completed on-line). Click here for information and to register.

The healthcare-influencing entity created by Amazon, Berkshire Hathaway, and JPMorgan Chase has named itself Haven. Its goal is to “create better outcomes, greater satisfaction, and lower costs for their U.S. employees and families.” Haven, which is based in Boston, is led by CEO Atul Gawande, M.D., a surgeon at Brigham and Women’s Hospital, Harvard professor, and noted author.

Its website notes that Haven is focused initially on “the U.S.-based employees and families from Amazon, Berkshire Hathaway, and JPMorgan Chase. In time, we intend to share our innovations and solutions to help others.”

Haven’s leadership team contains some names familiar to the Massachusetts healthcare community. Dana Safran, a former SVP of Blue Cross Blue Shield of Massachusetts, who focused on improvement and data analytics, is Haven’s Head of Measurement. Brooke Thurston, who was recently VP of Communications for Steward Health Care, is Haven’s Head of Communications.

Human trafficking is an ongoing public health threat that often goes undetected. The health system can play an important role in identifying and treating trafficking victims. From their immediate physical and emotional healthcare concerns to longer-term mental health and substance use issues, trafficking survivors often need a complex array of healthcare services. Mental health services are particularly important, as virtually all survivors have experienced some form of trauma. Because healthcare providers are in a unique position to identify victims and provide them with physical and psychological care – while in captivity and after release – it’s critical that caregivers can identify the signs and find strategies to help their patients. At this conference, leading national and regional speakers – as well as a survivor of human trafficking – will provide an overview of this public health issue and discuss strategies and resources that providers can integrate into their organizations to better treat patients victimized by human trafficking. Learn more about this important conference, taking place on Friday, April 5, from 8:30 am to 1:30 pm at MHA Conference in Burlington, by clicking here.