04.27.2020

Seek Care! Federal Funding. Senators Write HHS.

Need Care? Call Your Doctor or Go to the Hospital

If people are ill, in pain, or think something may be wrong with your health – related or unrelated to COVID-19 – they should call a doctor or, if need be, get to a hospital emergency department. If an individual or their family member or friend is having a mental health or substance use disorder issue, they should call a doctor or counselor or, if need be, get to a hospital ED. People who harm themselves through, say, a fall or kitchen accident, should get to an ED ASAP.

The healthcare system correctly curtailed non-essential surgeries and care at the outbreak of the crisis to free up room in hospitals in anticipation of the surge. People rightly deferred care to let the system respond. But those deferred health problems didn’t disappear. A person who, for example, put off joint surgery a month ago may be now in such debilitating pain that it’s affecting mobility and compounding other problems. Some people even may have had minor strokes or heart problems and are now at home afraid to seek care. The concern is that when people return to seek care their situations will have worsened.

Hospitals this week began an ad campaign to stress the need for people to visit EDs if needed. Hospitals are doing heroic work with COVID-19 patients but there’s a dual track available for non COVID-19 care.

As Dr. Michael Apkon, president & CEO of Tufts Medical Center, said at the governor’s press conference last Thursday, “We understand the fear people have. But what we want people to
know is that we’re keeping people safe at the hospital.”

 Dr. Gregg Meyer of Newton-Wellesley Hospital and Partners HealthCare said, “Let me assure you: Massachusetts hospitals are open for business.” And Nancy Shendell-Falik, R.N., president of Baystate Medical Center, informed the public that “chronic care and chronic diseases do not wait for this pandemic to subside.”

CARES Act Provider Relief Fund Update

On Friday, Massachusetts healthcare providers began receiving the second round of funding from the CARES Act Provider Relief Fund. In the first round, $30 billion had been distributed from the CARES Act fund to healthcare entities across the country based on Medicare fee-for-service payments in 2019. The second $20 billion installment represents additional funding as well as a reconciliation of the methodology used by the U.S. Department of Health and Human Services (HHS).

An additional $10 billion will be targeted to hospitals in COVID-19 high impact areas, which relates to the data submission that was due to HHS on Saturday. Another $10 billion will also be dedicated to support care provided to COVID-19 uninsured patients. In related news, MHA is collaborating with the Executive Office of Health and Human Services (EOHHS) on Health Safety Net COVID-19 patient billing, which will inform the federal funding.

On April 23, Congress passed the “Paycheck Protection Program and Health Care Enhancement Act.” The president signed it last Friday. This will add another $75 billion to the Provider Relief Fund, totaling $175 billion in grants. Given that the second funding round has come in below expectations and need, combined with the technical challenges and limitations of the HHS data request for COVID-19 hospital impacts, MHA is prioritizing future funding distribution with our state’s congressional delegation. MHA is advocating for financial relief that more appropriately reflects the current and prolonged COVID-19 effects on Massachusetts hospitals. (See related Warren/Markey letter.)

Markey, Warren Call for Clarity, Fairness in Funding

The commonwealth’s U.S. Senators Elizabeth Warren and Edward Markey called on the U.S. Department of Health & Human Services to more equitably distribute future federal relief funds relating to COVID-19. Through the CARES Act, Massachusetts providers received part of the $30 billion the federal government distributed earlier in April, as well as part of the $20 billion distributed last Friday. (See above story.) Warren and Markey said in their April 23 letter that HHS should recognize COVID-19 “hot spots” such as Massachusetts. They wrote: “Although Massachusetts represents 4.7% of all U.S. COVID-19 cases and 3.6% of all U.S. deaths (as of April 17, 2020), Massachusetts received only 2.8% of the $30 billion initially distributed. And although the funding Massachusetts received amounted to $44,000 per reported COVID-19 patient in the state, other states such as Minnesota, Nebraska, West Virginia, and North Dakota received more than $300,000 per reported COVID-19 case. HHS has acknowledged this deficiency, and suggested that coronavirus hot spots would be a priority for remaining funds.” Calling for more transparency in the funding process, the senators said clear criteria is needed or else “HHS could return to its previous practice of directing resources based on political motivations.”

Mass. House Passes Bill on DPH Reporting, Disparities Task Force

Last week the Massachusetts House passed HB4672, which mandates daily reporting from DPH regarding COVID-19. It also creates a task force to address disparities in the healthcare system during COVID-19; specifically it looks at how the health system is responding to underserved or underrepresented cultural, racial, ethnic and linguistic populations, as well as people with disabilities. A final report of the disparities task force would be due to the legislature by August 1, 2020, with interim recommendations due by June 1, 2020. The reporting directive includes a number of data elements that are already being collected and reported on a daily basis, but focuses specifically on demographic information, such as gender; race and ethnicity; primary city or town of residence; and age of individuals affected by COVID-19. Information compiled should also include whether individuals affected by COVID-19 speak English as a second language.

WEBINAR – Insights from the Frontlines: Caring for the Caregiver During COVID-19

Listen to this webinar recording to hear from the COVID-19 frontlines at UMass Memorial Health Care. Caregiver fatigue and burnout were a concern for hospitals before the COVID-19 pandemic. Responding to the current crisis and planning for a surge of patients, while not knowing what the future holds, are factors that only add to the strain on staff. The ability to care for caregivers is critical as hospitals continue to sustain a high-level operations tempo through the surge and well into recovery efforts, while ensuring the long-term capacity to care for communities. This webinar featured Thomas Ward, wellness program manager at UMass Memorial Health Care. The discussion moderated by MHA’s Senior Vice President and Chief Innovation Officer Valerie Fleishman includes specific tools and resources for supporting staff wellbeing.

John LoDico, Editor