ACA, Breakthrough Cases, Public Option, and more ...

DPH Wants Hospitals to Track Breakthrough Cases

Even though more than 50% of U.S. adults are now fully vaccinated against COVID-19 and the vaccine is highly effective, there have been “breakthrough cases” where the vaccinated still contract the virus. Some breakthroughs are relatively mild, but others are severe. In Massachusetts as of May 24, there have been 3,343 reported breakthrough instances in more than 2.9 million fully vaccinated individuals, according to DPH. A breakthrough case is defined as a person diagnosed with COVID-19 with a disease onset or positive laboratory result occurring more than two weeks after receiving a complete vaccine series.
Now DPH, at the request of the federal CDC, is asking hospitals to report those severe breakthrough cases that result in hospitalization or death. Tracking breakthrough cases in fully vaccinated persons helps analyze real-world vaccine efficacy, identifies waning immunity, and can signal the possible emergence of viral variants. DPH issued a reporting form to facilities last Tuesday.

Gathering Data to Help Address the ED Boarding Crisis

The emergency department boarding crisis affecting behavioral healthcare in the commonwealth demands ongoing real-time data to help determine the types of beds, workforce, and payment models needed to address the problem. MHA, other stakeholders, and the state are discussing an automated boarding data collection system, but until that is up and running, regular and consistent data is needed. MHA announced to its membership last week a weekly survey of psychiatric boarders in emergency department and on medical-surgical units, among other fields, that MHA hopes to make operational in mid-June. 

What Do You Think of the Public Health Insurance Option?

The public option – that is, a federally administered health insurance plan – is gaining steam in the Democratic-controlled Congress. Last week, the Chairman of the House Committee on Energy and Commerce Frank Pallone, Jr. (D-N.J.) and Patty Murray (D-Wash.), chair of Senate Committee on Health, Education, Labor & Pensions, released a letter seeking public comment on the proposal.
The committees seek answers to questions such as who should be covered, how should prices for care be determined, and what sort of premium assistance should the federal government offer? 
The American Hospital Association has consistently opposed a public option plan to lower the national uninsured rate, favoring expansion of already existing subsidized coverage through Medicaid, employer plans, and the marketplace. In a statement last week, the AHA wrote, “This type of proposal would strip significant resources from providers by relying on inadequate reimbursement rates, increasing the risk of hospital closures and threatening access to care for patients and communities.”

SCOTUS and the Affordable Care Act

The U.S. Supreme Court could issue a decision as early as next week on California v. Texas, the case that could sever the individual mandate from the rest of the Affordable Care Act.
The court heard oral arguments in November 2020, at which time speculation, based on traditional SCOTUS practice, predicted a decision in June 2021. In the case, the previous administration and 18 Republican state attorneys general challenged the ACA and the ability to sever the individual mandate “tax” – which is $0 – from the remainder of the law.

MHA’s Executive Insights Series

If you haven’t listened in yet on MHA’s Executive Insights series, mark your calendars for the next discussion: on Wednesday, June 23 from 8 to 8:30 a.m., MHA President & CEO Steve Walsh will interview Beth Israel Lahey Health President & CEO Kevin Tabb, M.D., and explore Tabb’s background, his thoughts on healthcare leadership, and his vision for the future of the healthcare system. Register for the free webinar here.
Previous Executive Insights featured Dr. Eric Dickson, president & CEO of UMass Memorial Health Care; Christine Schuster R.N., president & CEO of Emerson Hospital; Kate Walsh, president & CEO of Boston Medical Center; and Kevin Churchwell, M.D., president & CEO of Boston Children's Hospital. Recordings of those past discussions are here.

Memorial Day 2021

Throughout the past year we’ve used phrases like ”the war against COVID” or “arming ourselves" against the virus, and we've deservedly praised our courageous caregivers for being on the “front lines” of the "battle." But today – Memorial Day 2021 – we should reflect on those who have participated in actual armed conflict throughout our nation’s history and gave their lives in doing so. The National Moment of Remembrance Act, which became law in 2000, asks Americans “in a symbolic act of unity, to observe a National Moment of Remembrance to honor the men and women of the United States who died in the pursuit of freedom and peace.” The one-minute of silence is customarily observed at 3 p.m.

Transition – Bharel to Leave DPH

The Commissioner of the Department of Public Health Monica Bharel, M.D., is stepping down from the post, effective June 18. Bharel has held the commissioners post for more than six years. 
“Commissioner Bharel’s advocacy on behalf of the commonwealth’s patients has been nothing short of extraordinary," said MHA President & CEO Steve Walsh. "MHA and our members thank her for her service, and especially for her leadership in addressing the social determinants of health and health equity within our communities. Even in the face of unparalleled challenges, she has made Massachusetts a healthier place to live. We wish her the best of luck in her next chapter, and we look forward to continued collaboration with DPH as we continue moving toward our new normal.”
Margret Cooke, currently serving as DPH’s deputy commissioner and previously as general counsel, will serve as DPH's interim commissioner.

Emerging Hospital Technologies and Innovation Conference

Thursday, June 10; 8:15 - 11:30 a.m.

Healthcare innovation is on an accelerating trajectory. Now, hospitals and healthcare systems must be advancing systems and protocols to stay abreast of the rapidly evolving healthcare landscape. Register today for MHA's Emerging Hospital Technologies and Innovation Conference to learn more about the latest in virtual care, tele-behavioral health, the hospital-at-home movement, and more. Hear from local and national thought leaders in the innovation space through this thought-provoking learning opportunity. Register here.

John LoDico, Editor