INSIDE THE ISSUE

> Report on “Eds & Meds”
> Alternative EMS Transport
> DRIVE Act
> SNAP in the Courts

MONDAY REPORT

Chamber Report: “Eds and Meds” Are Backbone of State’s Economy

The Greater Boston Chamber of Commerce last week released a report entitled Anchored in Excellence: How Massachusetts’ Education and Healthcare Institutions Drive Regional Economic Growth that showed that the education and medical sectors of the economy produce $155.9 billion in annual economic output, support more than 858,000 jobs, and contribute nearly $4.1 billion in annual tax revenue to the state.

“While [Massachusetts] Eds and Meds directly employ hundreds of thousands of people, their economic reach extends far beyond their own campuses and facilities,” according to the report that was produced by Econsult Solutions, Inc., a Philadelphia-based consulting firm. “Through purchasing goods and services from local vendors and the subsequent spending by their employees, these institutions create a ripple effect that supports employment across diverse sectors of the Massachusetts economy.”

The Greater Boston Chamber produced a video to accompany the report, which features Kevin Tabb, M.D., president and CEO of Beth Israel Lahey Health; Anne Klibanski, M.D., president and CEO of Mass General Brigham; and Kevin Churchwell, M.D., president and CEO of Boston Children’s Hospital. Those three organizations are among the top employers in the state, just as all hospitals are a leading job-provider for their regions.

The report also found that although most educational and medical institutions in Massachusetts are non-profits, they contribute tax revenue to the state by employing staff that generate taxable income, and by purchasing services from vendors and employees in the private economy.

Universities and hospitals in the state also fund large capital improvement projects. According to the report, “The institutions’ aggregate annualized capital spending is approximately $4.8 billion (in 2025-dollar terms) within Massachusetts. These project costs include new construction, renovations, state-of-good-repair expenses, and the purchase and procurement of materials and services.”

In a panel discussion the Chamber held to introduce the report, MHA President & CEO Steve Walsh said the conclusions reached in Anchored in Excellence did not surprise him. “When we think about our hospitals – they’re the largest employers, largest philanthropic contributors, largest contributor to the community [from community benefits], largest purchaser, and they save lives every day,” he said. Yet, most people don’t think of hospitals as economic centers. “You don’t walk through the hospital and say, ‘Look at this economic engine. Boy, it’s humming!’ When we think of our healthcare system, we expect it to be there to take of us and our loved ones, so there is a disconnect between that and what our healthcare system does for our economy,” Walsh said.

Also participating on the panel were the President & CEO of the Massachusetts League of Community Health Centers Michael Curry; Rob McCarron, president & CEO of the Association of Independent Colleges and Universities in Massachusetts; and Chamber President & CEO James Rooney. The panel was moderated by Yvonne Hao, COO and general partner of Flagship Pioneering and the former Secretary of the Executive Office of Economic Development.

The Chamber/Econsult Solutions report determined that combined federal Medicaid and National Institutes of Health funding cuts in Massachusetts will lead to $5.9 billion in lost economic output and $142 million in lost state tax revenue.

“I’m sure that everyone in this room could share personal stories of an experience with our hospitals, our colleges, and how you came away with that feeling of thankfulness that we live in this region,” the Chamber’s Rooney said. “With all of that healthcare, education, and the economic impact you will see in this report, we cannot take these institutions for granted. We want our elected and appointed officials at all levels of government to consider the tremendous impact of the eds and meds as they weigh the implications of public policy and legislation and to develop a ‘how can we help’ mentality. Are we nurturing these institutions or hurting ourselves? … We want our broader business community to step up in unity with these institutions and continue to embrace their role in our economy.”

Save That Ambulance for When It’s Really Needed

Getting an ambulance quickly to a patient could be the difference between life and death for many people. So ensuring that ambulances are kept available for critical emergency transport, as opposed to being used for less urgent trips, is key.

Currently in Massachusetts, some hospitals are using re-configured SUVs staffed with emergency technicians to transport behavioral health patients. The vehicles have partitions and safety locks, medical equipment, and other additions for safe transport. They’re used for behavioral health patients because oftentimes the transport between an acute care hospital where a patient first arrives and the hospitals where there is an available psychiatric bed could entail hours of travel. Using a remodeled SUV rather than an ambulance is more dignified for the patient, frees up an ambulance that would otherwise be offline for the duration of the roundtrip, and reduces emergency department boarding by securing transportation for behavioral health patients more quickly.

The problem with this simple, practical, and patient-friendly solution is that no one is helping hospitals pay for such transport. Insurers will pay for medically necessary nonemergency transport in an ambulance. Hospitals alone are shouldering the cost for the innovative use of SUV transports.

Today at the State House, the Joint Committee on Mental Health, Substance Use and Recovery is holding a hearing on MHA priority bills, H.2234/S.1397, An Act Establishing Alternative Models for Behavioral Health Transport, sponsored by Rep. Adam Scanlon (D-North Attleboro) and Sen. Paul Feeney (D-Foxboro).

The straightforward legislation would require the Executive Office of Health and Human Services to establish five regional pilot programs to evaluate alternative models of transport for behavioral health patients, and it would require MassHealth to reimburse for the pilot-program services. The state would then collect data on the pilot programs and make recommendations on setting reimbursements for such services in the Medicaid and commercial markets.

“The intent of the bill is relatively simple – let’s see if this transport model that so far has proven successful in limited areas is scalable across the state,” said Leigh Simons, MHA’s V.P. of Policy & Regulatory Affairs.

The state’s Transitions from Acute Care to Post-Acute Care (TACPAC) Task Force included in its recommendations that the state should “explore the feasibility and funding for implementation of alternative behavioral health transportation models, … promote piloting behavioral health transportation alternatives focused on safety, patient-centered care, and cost effectiveness … [and] develop monitoring and evaluations frameworks for new transportation models.”

MHA & COBTH and Their Members Sign on to DRIVE Initiative

MHA and the Conference of Boston Teaching Hospitals last Thursday submitted testimony in support of Governor Maura Healey’s DRIVE Act – H.4375, An Act to Preserve and Advance Massachusetts’ Competitiveness in Discovery, Research, and Innovation for a Vibrant Economy.

A priority for the governor, DRIVE consists of a $200 million research funding pool housed at MassDevelopment, and another $200 million for public higher education campuses to support direct and indirect costs of research, cross-regional partnerships, joint ventures, and to preserve and hire positions in research and teaching. Half of the funding would come from the so-called “Millionaire’s Tax” and the other half from interest off the state’s stabilization fund.

In testimony submitted to the Joint Committee on Economic Development and Emerging Technologies, which held a hearing on the bill last Thursday, representatives from MHA and COBTH signaled their “strong support” for DRIVE, saying, “This proposal builds on the commonwealth’s outstanding leadership and partnership in supporting the hospitals and academic research centers that continue to serve as the lifeblood of our economy – creating jobs, strengthening local communities and economies, improving public health, and advancing the therapies and cures that cannot come soon enough for so many patients and families around the world.”

Representatives from Boston Children’s Hospital and Dana-Farber Cancer Institute offered their enthusiastic support for the proposal at the Thursday hearing.

“The reason we so strongly support this DRIVE legislation is because it supports this virtuous cycle from academic research to biotech to pharma and back to patient access,” said Irene Abrams, senior vice president for research innovation at Boston Children’s Hospital. Abrams cited the breakthrough sickle cell treatment made possible through research and investment at Children’s, Harvard, MIT, CRISPR Therapeutics, and Vertex Pharmaceuticals.

One part of the legislation – creation of the Commonwealth Federal Matching, Fiscal Resilience, and Debt Reduction Fund – is intended to improve the financial stability of safety net hospitals and community health centers in Massachusetts.

The testimony was signed by representatives of MHA, COBTH, Boston Children’s Hospital, Mass General Brigham, Harvard Medical School, Dana-Farber Cancer Institute, UMass Memorial Health, Beth Israel Lahey Health and Beth Israel Deaconess Medical Center, Tufts University School of Medicine, Tufts Medicine, Boston University Chobanian and Avedisian School of Medicine, and Boston Medical Center Health System.

Decisions on SNAP Come Down to the Last Minute

Judge Jack McConnell of the U.S. District Court for the District of Rhode Island on Friday ordered the Trump administration to use an emergency reserve to fund Supplemental Nutrition Assistance Program (SNAP) distributions that the administration had previously announced would end on Saturday, November 1 due to the government shutdown.

McConnell’s oral decision requires the administration to begin paying SNAP benefits to states “as soon as possible.”

Almost at the same time on Friday, another U.S. District Court Judge in the Massachusetts District, Indira Talwani, issued a written memorandum and order saying that the case before her to stop the SNAP cuts, which was brought by 22 state Attorneys General including Massachusetts AG Andrea Campbell, was likely to succeed based on its merits.

Specifically, Talwani said that in 2024 the U.S. Congress appropriated $6 billion to SNAP to be used as a contingency reserve through 2026. “Where there are at present no new appropriations for fiscal year 2026, this contingency reserve, which Congress specifically appropriated for use when funding is ‘necessary to carry out program operations,’ is available to [the U.S. Department of Agriculture] and must be deployed to fund SNAP benefits,” Talwani wrote.

While the AGs’ call for a temporary restraining order remains under advisement, Talwani ordered the administration, no later than today (Monday, November 3) to inform the court whether it will at least authorize reduced SNAP benefits for November, or if it will authorize full SNAP benefits using the contingency fund and additional available funds. (Due to the fluidity of the situation, a final decision on the issue may not be captured in time for this Monday Report.)

Currently, 1.1 million people – or nearly one in seven residents – receive SNAP benefits in Massachusetts each month, including approximately 665,000 families, 342,000 children, and 261,500 elderly individuals. Households in Massachusetts receive on average $323 per month in SNAP benefits.

John LoDico, Editor