The latest report from the state showing hospital and physician practice finances during the pandemic describes a fairly bleak picture of how COVID-19 affected the facilities that have taken unprecedented steps to stem the virus.
 
The report from the Center for Health Information & Analysis (CHIA) shows that if it were not for federal and state funding ($1.6 billion and $205 million, respectively) the median total margin of hospitals would have been negative 4.2% in fiscal year 2020. Even with the federal funding, the median operating margin on hospitals was a relatively small 1.3% – a decrease of 1.2 percentage points in comparison to the previous year. Net patient service revenue – which CHIA terms “the most significant component of operating revenue” – dropped by $1.4 billion and hospitals’ expenses grew by $1.3 billion. 
 
Eight of 22 reporting hospitals systems had negative total margins while 40 of 47 affiliated physician organizations reported a net loss for FY 2020. 
 
“This preliminary data from CHIA confirms the tremendous financial challenges providers have faced throughout the pandemic,” said MHA’s President & CEO Steve Walsh. “Healthcare organizations have spared no cost to rapidly adjust capacity, secure protective equipment, and mount vaccination sites across the state. Meanwhile, patient visits dropped dramatically as elective procedures and other in-person services were put on hold.”
 
Walsh cited the federal and state relief as the key to allowing “hospitals to stabilize and remain open for their patients throughout the crisis,” and noted that hospitals transferred some of their relief to support affiliated physician groups and other entities, which also experienced significant losses according to CHIA.
  
“Additional financial support is needed as our providers continue their response and navigate a new normal,” Walsh said. “MHA thanks our elected leaders on Beacon Hill and in Washington D.C. for their continued support of our healthcare organizations. The financial recovery of our providers is essential to their ability to deliver world-class care.”
 

The state and hospital community want to get the word out that the American Rescue Plan that President Biden signed last month increased the subsidies that people can receive to get health insurance coverage through the state’s Health Connector.
 
The financial help available to help pay for insurance through the Affordable Care Act has been increased, which means most people who already get help paying for insurance will get more support, and many people who used to not qualify for help will now see lower monthly premiums. The Health Connector is currently in an extended open enrollment period through July 23, 2021. 
 
The new financial help is available immediately in Massachusetts. More details are available at this Health Connector page.

On April 6, the Democratic chairs for key congressional healthcare committees wrote a letter to Department of Health and Human Services Secretary Xavier Becerra asking that HHS establish a special enrollment period for COBRA. The American Rescue Plan provided a six-month extension of fully subsidized COBRA coverage and allows individuals to enroll in the Affordable Care Act plan once the COBRA coverage ends. Without a special enrollment period, consumers will either need to pay the full cost of COBRA or possibly go uninsured for three months until the open enrollment period starts November 1. HHS has broad authority under the ACA to set up special enrollment periods as needed, but no response yet from Secretary Becerra.

One of the regulatory flexibilities instituted during the pandemic by both federal and state governments require health insurance companies to waive prior authorization rules to enable providers to move people through the health system more efficiently.   Now, a new study from the American Medical Association (AMA) finds that almost 70% of 1,000 practicing physicians surveyed in December 2020 reported that health insurers had either reverted to past prior authorizations policies or never relaxed these policies in the first place. More than nine in 10 physicians (94%) reported care delays while waiting for health insurers to authorize necessary care, and nearly four in five physicians (79%) said patients abandon treatment due to authorization struggles with health insurers.   Nearly one-third (30%) of physicians reported that prior authorization requirements have led to a serious adverse event for a patient in their care, according to the AMA survey. Medical practices complete an average of 40 prior authorizations per physician, per week, which consume the equivalent of two business days (16 hours) of physician and staff time. To keep up with the administrative burden, two out of five physicians (40 %) employ staff members who work exclusively on tasks associated with prior authorization.   On a related note, last week the Massachusetts Division of Insurance released a bulletin that, among other things, reminded insurers in the state that they must provide coverage for COVID-19 treatment without prior authorization, including transfers to rehab facilities and home care.

Following President Biden’s release last week of his American Jobs Plan to address infrastructure and economic investments, healthcare organizations ramped up their push for Congressional action on key health priorities. The American Jobs Plan has limited focus on healthcare, with investments in Medicaid home and community-based care, and on medical research and supply chain issues. But the Biden Administration and Congressional Democratic leadership have signaled that there might be another announcement this month that addresses the effect of COVID-19 on healthcare delivery. 
  
In anticipation of the next big legislative plan, the American Hospital Association released a detailed letter to President Biden with recommendations for investing in hospital and health system physical infrastructure, rebuilding capacity for emergency preparedness, and expanding healthcare digital and data infrastructure.
  
House Speaker Nancy Pelosi (D-Cal.) said last week that everything is on the table, including drug pricing proposals that may help raise sufficient revenue to offset some of the costs of the jobs plan’s proposals. Pelosi has also stated that she hopes to get a bill on the floor of the House by mid-July.

The premise of the Risky Business conference is relatively simple: learn from thought leaders in high-risk industries to improve healthcare safety and quality. This is more critical now than ever, at a time when nearly every sector has had to adapt and innovate due to COVID-19. Risky Business speakers include Patriots Coach Josh McDaniels, Lieutenant Colonel Sue Gannon, Dr. Don Berwick, and more. They will discuss topics such as equity, leadership, teamwork, and managing logistical challenges. The free virtual forum takes place on Thursday, April 15, from noon to 2 p.m. ET. Register here.

Tomorrow, MHA and the Massachusetts Behavioral Health Partnership (MBHP) are holding a webinar about MBHP’s Massachusetts Child Psychiatry Access Program for Autism Spectrum Disorders and Intellectual Disabilities (MCPAP for ASD-ID).
 
MCPAP for ASD-ID was launched on July 1, 2020, to support Emergency Services Program/Mobile Crisis Intervention providers working with youth and young adults with ASD or ID, who are having a behavioral health crisis. Now the program is being made available to all emergency department providers. The free consult line provides on-demand consultations, regardless of an individual’s insurance status. Initial consultations are with a licensed applied behavior analyst, and follow-up consultation with physicians with ASD expertise may take place when needed. The consult line is available seven days a week from 11 a.m. to 7 p.m. and is funded by the Executive Office of Health and Human Services.

Although the personal protective equipment (PPE) market has somewhat stabilized from where it was six months to a year ago, healthcare entities and others still face challenges in procuring some items, and cost is still a significant issue. As part of its continuing efforts to connect Massachusetts healthcare organizations with high-quality PPE, MHA recently partnered with the new wholesale medical supplier and distributor – bttn (pronounced “button”). 
 
The company aims to provide a long-term solution beyond the COVID-19 crisis for improving access to medical supply products at the manufacturing price for organizations of all sizes. Bttn has established relationships with manufacturers, a partnership with UPS, and access to nationwide warehousing. 
 
MHA will be hosting an informational webinar led by bttn on Wednesday, April 14 at 1 p.m. JT Garwood, CEO of bttn, will provide an overview of the company, walk through the group purchasing process, and answer questions. Registration for this free webinar is available here; it is open to MHA members and non-members.
 
Following the webinar, bttn will open up the first bulk purchase opportunity for healthcare providers in Massachusetts for a limited time, from April 14-23. Use this code at checkout to receive 10% off your total purchase: MAPPE1. The company accepts all forms of payment, including credit, wire transfers, purchase orders, and net terms. Please contact MHA’s Kim Stevenson (kstevenson@mhalink.org) with any questions.

The Schwartz Center for Compassionate Healthcare has extended until April 19 the deadline for submitting nominations for the National Compassionate Caregivers of the Year Award. Up to six award recipients will be chosen by a national review committee. Nominees may include healthcare professionals and interdisciplinary teams of healthcare professionals. The Schwartz Center will accept nominations for clinical and non-clinical providers, administrators, educators, and others who provide direct or indirect care to patients, families, and/or healthcare staff. Submit a nomination here.

Peter Slavin, M.D., the president of Massachusetts General Hospital since 2003, has announced he will step down from his post once his replacement has been chosen. In addition to continually improving the clinical excellence of MGH and expanding its affiliations and programs, Slavin is widely credited for his leadership in promoting diversity, equity, and inclusion in the healthcare and community space. He served as MHA’s Board of Trustees Chair in 2012-13, and chaired the Association of American Medical Colleges, among many other professional achievements. 
  
MHA President & CEO Steve Walsh said of Slavin, “He has been more than just the leader of one of the world’s finest healthcare institutions. Over the years, Dr. Slavin has been a leader on behalf of our entire healthcare community. Through both his time on the MHA board and the example he has set at MGH, he has pushed us to be a better, more innovative system for patients. We thank Dr. Slavin for his tremendous contributions to MHA and to hospitals across the state.”
  
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Tom Sands has been named president of Beverly and Addison Gilbert Hospitals. Most recently, Sands served as president of Carney Hospital, the 159-bed facility in Dorchester. Previously, he was COO at Good Samaritan Medical Center in Brockton. Sands came to Massachusetts from Georgia, where he spent 20 years at Navicent Health, a 637-bed teaching hospital. He began his healthcare career as a certified pulmonary functions technologist at Emory University Hospital. 
  
Sands earned master’s degrees in business administration and health administration from Georgia State University and his bachelor’s degree in biology from Morehouse College. 

MHA’s Spring Forward Leadership Summit

Thursday, April 29; 9 a.m. – 12 p.m. ET  

2021 is a year to look ahead in healthcare, but with forward-looking vision comes the need for ever-evolving leadership skills. Register today for MHA’s inaugural Spring Forward Leadership Summit to hear from top thought leaders on the future of the healthcare workforce, health innovation, and health policy. Learn effective patient engagement strategies in the ever-transforming virtual world and hear from a panel of local CEOs on what healthcare leaders can expect in 2021. Don’t miss out on this invaluable learning opportunity. Register today by clicking here.