11.23.2020

Doctors, Nurses Urge Holiday Caution

Chief Medical and Nursing Officers Urge Caution During Holidays

With the continued surge in COVID-19 hospitalizations, along with the upcoming holidays, Chief Medical Officers and Chief Nursing Officers from hospitals across the state have signed on to this letter in a coordinated effort to urge the public to remain diligent in following public health measures and to limit any holiday gatherings.

“Keep your in-person celebrations small and remember that the state has limited indoor gatherings to 10 or fewer people. Set up your meal tables to allow for distance between each person and avoid sharing drinks, food or utensils. Celebrate outside if at all possible. And be especially mindful of seniors or those with chronic conditions who may be present,” the health leaders stress.

“Let creativity play a role. Set up virtual check-ins, organize drive-by celebrations, and find ways to embrace the extraordinary circumstances of these times. We know these adjustments are not easy. But they are essential in keeping our communities healthy and allowing our hospitals and healthcare organizations to keep up with demand.”

State Senate Passes Budget

The Massachusetts Senate unanimously approved its FY21 budget proposal on Wednesday, November 18, adopting amendments during debate to authorize increasing fees on ride-sharing applications and to codify and expand abortion access.
 
The final budget included a Sen. Bruce Tarr (R–Gloucester) amendment to direct the Office of Preparedness and Emergency Management to develop and implement an online personal protective equipment (PPE) inventory tracking, management, and procurement system. The final amendment language specifies that the system must include a mechanism for healthcare providers to report existing stocks of PPE, outstanding and anticipated orders of PPE, disruptions in supply chains, incidents of price gouging, and projected need for PPE. The system must also contain a database of PPE suppliers, a mechanism for bulk or coordinated procurement of PPE, and a mechanism for healthcare providers to alert the office to an impending supply shortage.
 
The Senate also endorsed Amendment #237 sponsored by Sen. John Keenan (D – Quincy) that would direct the Executive Office of Health and Human Services to study the rate differentials for inpatient psychiatric and substance use hospital per diem payments between MassHealth and its contracted health insurers, health plans, health maintenance organizations, behavioral health management firms, and third-party administrators.
 
Included in the budget is $10 million for grants to retrofit healthcare spaces to increase inpatient psychiatric capacity, with priority given to creation of beds for children and adolescents, and for beds located in underserved areas of the commonwealth.
 
Notably, in light of hospitals and the healthcare system still being mired in the pandemic, the Senate budget is short on mandated increased expenditures, burdensome required studies, or other administratively or financially problematic directives. 
 
House-Senate conferees will now meet to craft a final budget to send to the governor.
 

Health Council Tweaks Language to Prepare for COVID-19 Vaccine

As the development of COVID-19 vaccines accelerates and as flu season kicks into high gear, the Public Health Council last week took action on a question of great importance to MHA and the hospital community – who will be able to administer vaccines?
  
The DPH commissioner already has legal authority to authorize healthcare professionals and medical and nursing students to possess and administer influenza vaccine. The health council amended that regulatory authority to allow the commissioner to authorize people to administer “any vaccine” designated by the commissioner to fight “vaccine-preventable” diseases. That language was needed to cover future COVID-19 vaccines. Medical and nursing students still have to be authorized and supervised by a licensed and qualified healthcare professional.
  
Hospitals, which will eventually face an enormous influx of individuals seeking a vaccine, supported the Public Health Council’s action.
 

Health Sector Employment Drops During Pandemic

At its board meeting on November 18, the Health Policy Commission (HPC) presented data on how the health system is coping with COVID-19.
 
The HPC found that emergency department and inpatient visits in Massachusetts dropped dramatically due to COVID-19, with both remaining below 2019 levels through September 2020. The drop in healthcare employment in Massachusetts has been larger than in the U.S., except for hospital employment which fell by 0.7% in the Bay State as compared to the 2.1% drop nationwide. Physician offices and outpatient care centers suffered great employment losses, with Massachusetts nursing and residential care facilities and home healthcare experienced a 9.4% drop in employment compared to a 5.5% drop nationwide. The numbers are from August 2020 relative to February 2020. 
 

MHA Weighs in on ACO Certification

The Health Policy Commission (HPC) is proposing updates to the requirements for ACO certification, effective for two-year certification terms that begin on January 1, 2022. Currently, there are 17 HPC-certified ACOs in the commonwealth serving nearly 3 million attributed patients. 
 
In its comments to the HPC, MHA fully supports the HPC goals but expressed concerns that some of the new requirements will be administratively burdensome or need more clarity. Given the resurgence in COVID-19, MHA is recommending that the HPC allow more time to comply with the new standards and consider working with stakeholders to develop survey tools that would enable all ACOs to address health equity issues using comparable data.
 

Opioid Deaths Inch Up; BSAS Addresses Addiction During Pandemic

DPH reports that there have been an estimated 33 more opioid-related deaths in Massachusetts during the first nine months of 2020 than there were during the same period in 2019.
 
Confirmed and estimated opioid-related overdose deaths from January to September 2020 – in the midst of the pandemic – totaled 1,517, according to the DPH report. 
 
DPH estimates that the rate of opioid-related overdose deaths stabilized in 2019 compared with 2018. This follows an estimated 2% decline in the rate of opioid-related overdose deaths from 2017 to 2018. The 2019 rate represents an estimated 5% decrease from 2016. The final tally for 2020 will not be known until well into 2021. Health officials and policy makers will be looking to see how the economic and social stress points associated with the pandemic affects substance use disorder.
 
The state’s Bureau of Substance Addiction Services (BSAS) reported to the Public Health Council last week about its response to COVID-19. It increased access to naloxone and implemented the broad adoption of a DEA waiver allowing prescriptions for buprenorphine and naltrexone to patients for whom providers have conducted telehealth sessions, among other actions.
 
BSAS says in specific response to the pandemic it is investigating the increased risk of overdose due to social isolation, changes to the drug supply, underutilization of treatment for fear of infection, and the economic and mental health toll of the pandemic. It is also investigating the risk of program closures and/or reduced bed capacity in treatment programs due to financial strain from low bed utilization and increased costs of operation, COVID outbreaks among patients and staff, and staffing shortages.
 
 

Donovan of Heywood Healthcare’s Telehealth Program Honored

Maureen Donovan, program manager of the Tele-Behavioral Counseling Program at Athol Hospital campus, which is part of Heywood Healthcare, has received national recognition for her innovative telemedicine efforts.

 

The National Association of State Offices of Rural Health featured Donovan along with recipients from the 49 other states in its 2020 Community Stars publication.

 

The telehealth program that Donovan oversees with a staff of six brings counseling services to students within area school systems. Through the program, students don’t have to travel to and from school and miss hours of instruction to make face-to-face appointments. The program is especially beneficial due to the rural aspect of the North Central Massachusetts area it serves.

 

Students, who are accustomed to spending time online, are receptive to speaking to counselors remotely. More than 3,000 sessions have been conducted online.

 

MHA featured the program in this video last year.

AG Healey’s Report on Persistent Health Inequities

Attorney General Maura Healey released a report last week that focuses on the persistent problem of health inequities within the healthcare system.
 
The report – Building Toward Racial Justice and Equity in Health: A Call to Action – calls for action in five areas: data for identifying and addressing health disparities, equitable distribution of healthcare resources, telehealth as a tool for expanding equitable access to care, healthcare workforce diversity, and social determinants of health and root causes of health inequities.
 
Earlier this year, MHA created the board-level Standing Committee on Diversity, Health Equity and Inclusion. Steve Walsh, MHA president and CEO, welcomed the AG’s report, saying, “We applaud Attorney General Healey for her continued focus on health equity and for the important work her office is doing to create structural change in the commonwealth. For too many residents, systemic racism and socioeconomic status have been barriers to quality healthcare. Our providers remain committed to being an active part of the solution. The Attorney General has always been a fierce advocate for our patients, and we stand with her in our shared mission to deliver the accessible, equitable care they deserve.” 
 

Mass. Delegation Gets Even Stronger in D.C.

Four-term Massachusetts Member of Congress Katherine Clark (D) last week secured the position of Assistant Speaker of the U.S. House of Representatives – the fourth most senior leadership spot.

 

“We at MHA extend congratulations to Congresswoman Clark on her well-deserved election to Assistant Speaker – making her the second-highest ranking Democratic woman in the history of the House,” said MHA President & CEO Steve Walsh. “Throughout her career in public service, she has been a tireless advocate for the Massachusetts healthcare community, delivering for providers, patients and their families. As we work toward our common goal of building a healthier nation, we are energized by Congresswoman Clark’s leadership and will continue to work alongside her and the entire Massachusetts delegation.”

 

The top four posts in the Democratic caucus are now Speaker Nancy Pelosi (Calif.), Majority Leader Steny Hoyer (Md.), Majority Whip James Clyburn (S.C.), and Clark.

 

Clark’s elevation will add to the clout of the Massachusetts delegation once the 117th Congress is convened on January 4. Amongst others of note, Rep. Richard Neal (D) will return as chair of the House Ways & Means Committee and Jim McGovern (D) returns as chair of the Rules Committee.

Treating Pregnant and Postpartum Patients with OUD

The American Society for Addiction Medicine (ASAM) and the American College of Obstetricians and Gynecologists (ACOG) have partnered to offer a Treatment of Opioid Use Disorder course online. The curriculum, created for women’s healthcare professionals, focuses on treating pregnant and postpartum patients with OUD and equipping participants with the education needed to obtain the waiver to prescribe buprenorphine. 
 
The course is structured with four hours of self-paced online learning and four hours of live webinar instruction and costs just $25.
 
Learn more and register now at the ASAM website.
 

 

Leveraging ACOs and Value-Based Care in Healthcare’s New Normal

Thursday, December 3; 8:30-11 a.m. ET (Virtual Meeting)

ACOs and value-based care models continue to move forward despite the frequent changes in government and regulatory policies. Providers have kept their eyes on the ball and pushed care to ambulatory settings, re-focused resources, and in recent months transformed to telemedicine almost overnight. At this program we’ll take a look at the current challenges, concerns, and successes in providing the best care to patients at the most affordable costs. We’ll look at the potential effects of the telemedicine revolution and what the near future may hold for value-based care and successful models for providers. The target audience is chief nursing officers, chief medical officers, population health leaders/staff, data analytics staff, clinical and quality staff. Click here to learn more.

John LoDico, Editor