The Cost Growth Benchmark

Vaccines for the Homebound

As people in the commonwealth await their turn to travel to one of the state’s vaccine sites, some individuals are facing the problem of not being able to leave their homes to get vaccinated. These homebound individuals either require an ambulance or the assistance of two or more people to leave their homes, or face some other difficulty that makes it difficult for them to get a vaccine anywhere other than where they are living.

Such individuals or their caretakers can call the state’s Homebound Vaccination Program Central Intake Line at 1-833-983-0485, Monday through Friday, from 9 a.m. to 5 p.m. Assistance is provided in English and Spanish, and translators will be available to support residents in approximately 100 additional languages. 

If in-home vaccination is appropriate, the person will be registered with the State Homebound Vaccine Provider, Commonwealth Care Alliance, or will be referred to their local Board of Health based on where they live and whether the local board provides in-home vaccination services. MHA has had several meetings with the state to coordinate outreach to homebound individuals.

This document provides full details on the program.

U.S. HHS Report Notes Effects of Hospitals Operating in “Survival Mode”

The U.S. Department of Health & Human Service’s Office of Inspector General (OIG) has released a report showing that the ongoing stresses of the pandemic – different than those experienced during the initial chaotic months of COVID-19, but still substantial – have affected hospital operations.

The report is based on a “pulse survey” conducted in February 2021 of 320 hospitals nationwide, including five in Massachusetts. Among other concerns, hospitals reported staffing shortages, exhaustion, and trauma that have taken a toll on staff’s mental health; challenges with vaccine distribution and vaccine hesitancy; and concern that the pandemic has exacerbated existing disparities in access to care and health outcomes.

“Additionally, many hospitals reported experiencing financial instability because of increased expenses associated with responding to a pandemic and lower revenues from decreased use of other hospital services,” according to the OIG report.

Of concern is the effect of the pandemic going forward, even as vaccinations increase. According to the report, “COVID-19 patients with longer-term effects will also need complex specialty care. Hospitals reported seeing patients with serious post-COVID conditions, such as pulmonary issues, pneumonia, heart problems, and blood clots. One hospital described ‘a tsunami of people going forward’ who they predicted would experience long-term effects from COVID-19.”

EOHHS Seeks to Amend Waiver

The state’s Executive Office of Health & Human Services (EOHHS) announced last Tuesday that it is seeking to amend the current MassHealth Section 1115 Demonstration waiver to, among other things, expand eligibility for the Medicare Savings Program; expand postpartum coverage, including for those who formerly could not receive it due to their immigration status; expand community-based substance use disorder services for criminal justice-involved populations; and to make permanent certain COVID-19 flexibilities regarding the place of service for care. 

EOHHS is holding a public listening session on the amendment on Wednesday, March 31 at 2 p.m. It will accept comments on the amendment through April 25. The amendment, and details on the listening session and comment submissions are all located here.

This proposed amendment of the current waiver is different from the ongoing process to create a new, five-year waiver that will go into effect in FY23.

Little-Used Law Allows 12-Month Supply of Contraceptives

A February 2021 article in Commonwealth magazine by reporter Sarah Betancourt has focused attention on a 2017 law that among other things allows women to receive a 12-month supply of birth control, instead of requiring them to visit a pharmacy each month. The problem, the article pointed out, is that no one promoted the 12-month provision so hardly anyone took advantage of it. 

According to the article, “Insurers didn’t promote the option to the 1 million women eligible to take advantage of it and even denied coverage to some who asked for it. Pharmacists claimed ignorance, and often told women the provision in the law didn’t exist. As a result, only about 300 women obtained a 12-month supply of birth control last year through the state’s largest insurers.”

Last week, insurers said they’d begin a campaign to educate the public. The law also requires nearly all forms of birth control to be covered with no co-pay. Healthcare providers should have the ability to submit a full 12-month supply of birth control via existing health information technology programs in hospitals.

Senate Advances Extension of 2% Medicare Sequester Moratorium

The U.S. Senate has passed an amended version of the bill, HR 1868, which the House passed last week, to extend the 2% Medicare sequester moratorium. The current moratorium expires on March 31 and the amended Senate bill would extend it through December 31, 2021. The bill includes an offset to pay for the extension that helps avoid the PAYGO budget rule, which would have resulted in across-the-board cuts in programs like Medicare.

The amended Senate bill returns to the House for a final vote, and that vote is expected when the House returns from its district work period break the week of April 12. If enacted, the moratorium would be applied retroactively to March 31. CMS can hold claims up to 14 days and often does so if Congress is nearing passage of legislation likely to affect those claims, as is the case with this sequestration moratorium.

MHA had urged the state's congressional delegation to support the extension and thanked Massachusetts Senators Elizabeth Warren and Ed Markey who joined the majority on the 90-2 Senate vote, as well as thanking the House delegation that voted yes on March 19.

App Developed at Boston Medical Center Assists OUD Treatment

Boston Medical Center has developed a free app – BMC MAT – that provides guidelines and resources to treat opioid use disorder (OUD) with medication (buprenorphine or naltrexone) in office-based settings. The app walks clinicians through each step of the decision-making process for treating patients with OUD, and provides access to several diagnostic tools and tests. BMC MAT is available through the Apple iTunes store and Google Play.

According to the Centers for Disease Control and Prevention, more than 81,000 drug overdose deaths – the highest on record – took place in the U.S. during the 12-month period ending in May 2020. Research has demonstrated that medications for addiction, such as buprenorphine or naltrexone, greatly reduce the risk of all-cause mortality and overdose death in people with OUD; however, such life-saving medications are underutilized. 

The app was funded in part by the Substance Abuse and Mental Health Services Administration through the Opioid Resource Network and the Massachusetts Department of Public Health.

Transition

Mass General Brigham has named Ross Zafonte, DO as the interim president of Spaulding Rehabilitation Network. Zafonte is currently chief of Physical Medicine and Rehabilitation at Mass General Hospital and Brigham and Women’s Hospital, and SVP of Medical Affairs, Research, and Education at Spaulding Rehabilitation Network. He will maintain his current responsibilities as he begins his new role immediately. MGB said it would align its search process for a permanent president with its Mass General Brigham United Against Racism initiative, and will include a diverse search committee and slate of candidates for consideration.

Focus on DHE & I: Diversity, Health Equity, and Inclusion Best Practices

As part of its commitment to champion diversity, health equity, and inclusion, the Massachusetts Medical Society and the Massachusetts Health & Hospital Association have partnered to host a series of webinars to encourage dialogue and share best practices. The webinar series will address: creating a culture of inclusion and belonging, leadership and accountability, pipeline advancement programs, and moving data into action around health equity. Register today to advance your skills around DHE & I best practices! All webinars will be held on Wednesdays from 12-12:45 p.m.

 Wednesday, April 14: Creating a Culture of Inclusion and Belonging
Wednesday, May 12: Leadership and Accountability
Wednesday, June 9: Pipeline Advancement Programs
Wednesday, July 14: Moving Data into Action