INSIDE THE ISSUE

> Schuster to Lead MHA Board
> Curbing Healthcare Violence
> Lane Award: Banks
> MHA Recognizes Healthcare Heroes
> Gov. Healey Addresses Annual Meeting
> BMC Walsh is new EOHHS Secretary
> Labor Secretary Walsh
> HPC’s Strong Telehealth Recommendations
> MassHealth Redeterminations
> Primary Care Dashboard

MONDAY REPORT

Christine Schuster Elected Chair of MHA’s Board of Trustees

“It is a distinct honor to take on the position as MHA Board Chair at this pivotal time for the Massachusetts healthcare system,” said Schuster. “The challenges facing our providers are well known, and we will continue our focus on the state of the workforce, patient bed availability, and the overall viability of a stretched system. We are also prepared to embrace every opportunity to define the future of care delivery. This organization has never been more focused on making healthcare better for patients and caregivers alike.”

Schuster begins her tenure as MHA’s 82nd Board Chair at a time when severe capacity constraints, vast workforce shortages, deep financial instability, and new reforms significantly affect care delivery.

Schuster is a long-time advocate for equal representation for women in healthcare leadership, and is regarded as a champion for community hospitals, having served as president and CEO of Emerson Health for 18 years. Prior to leading Emerson, she was CEO of Quincy Medical Center and Athol Memorial Hospital. She also serves as Board Chair for the Massachusetts Council of Community Hospitals. Schuster was considered a “go-to” leader during the height of the COVID-19 pandemic, in which she collaborated with leaders from large systems and community hospitals throughout the commonwealth to ensure bed availability for patients, and access to critical supplies, and resources.

“As long as I have known her, Chris has embodied the commitment and advocacy that are hallmarks of the Massachusetts healthcare community,” said MHA president & CEO Steve Walsh. “Her background as a nurse, mentor, and longtime CEO makes for a perfect combination to meet the needs of today. We are excited for what 2023 will bring as Chris leads our efforts to uplift patients and healthcare professionals across Massachusetts.”

The newest members of the MHA Board of Trustees, joining the full slate of members, are Laurie Glimcher, M.D., president & CEO, Dana-Farber Cancer Institute; Robert Higgins, M.D., president, Brigham & Women’s Hospital, and EVP, Mass General Brigham; Nancy Gaden, R.N., Senior VP & Chief Nursing Officer, Boston Medical Center; and Darlene Rodowicz, president & CEO, Berkshire Health Systems.

MHA’s Executive Committee for 2023 is Chair Schuster; Chair-elect Kevin Tabb, M.D., president & CEO, Beth Israel Lahey Health; Treasurer Michael Lauf, president & CEO, Cape Cod Healthcare; Secretary Anne Klibanski, M.D., president & CEO, Mass General Brigham; Immediate Past Chair Churchwell; Past Chair Most Recently Retired Eric Dickson, M.D., president & CEO, UMass Memorial Health; and MHA President & CEO Walsh.

A Violent Act Every 38 Minutes
MHA Members Issue United Call to Action on Healthcare Facility Violence

Last week, the MHA Board of Trustees endorsed the United Code of Conduct Principles, which include measures to promote a safe and respectful environment, examples of what potential violations look like, proposed consequences for violations, and recommendations for maintaining the principles long-term. The effort is a part of MHA’s larger workforce initiative to support and grow the commonwealth’s base of talented healthcare professionals.

“Healthcare workers are under more pressure than at any time in history, and violence will never be a part of their job description,” said Steve Walsh, president & CEO of MHA. “Hospital and health system leaders recognize this, are doing everything in their power to mitigate unacceptable behavior in their facilities. But they cannot do it without the help and support of community members. This effort is about taking a stand for the wellbeing of caregivers in a way that every one of us can control.”

“These principles set firm, direct expectations among everyone who enters a healthcare facility in Massachusetts – no matter where that might be,” said Therese Hudson-Jinks, R.N., Chief Nursing Officer, Chief Experience Office, and Senior VP of Patient Care Services at Tufts Medical Center. “Healthcare facilities are a place of refuge. Great patient care is only possible when all of our employees – from nurses and physicians to security personnel and administrative staff – feel safe and secure.”

Over the past three years, MHA has conducted a monthly survey of Massachusetts hospitals to track the frequency, location, and types of violence committed on their campuses. The 56 responding acute and post-acute hospitals across the commonwealth provided data revealing that every 38 minutes in a Massachusetts healthcare facility there is a case of physical assault, verbal abuse, or threats made against someone – most often a clinician or staff member. Nurses report the most (38%) incidents of workplace violence, followed by security personnel (27%), and other clinical staff (19%).

The new report includes data on abusive incidents, as well as the solutions MHA members are championing to protect healthcare professionals. This new legislative session, MHA has again filed comprehensive violence prevention legislation at the State House.

Spaulding Rehab’s Maureen Banks Receives MHA’s Lane Award

The award recognizes a hospital or health system leader for their exceptional efforts on behalf of their organization and the healthcare system at-large. It was established in 2004 to embody the spirit of William Lane, who served as a hospital CEO for more than 30 years and was an ardent advocate for patients and hospitals.

This year Banks is concluding her service as COO and CNO after more than 20 years of leadership in post-acute care. In presenting the Lane award, MHA highlighted Banks’ legacy as a champion for professional growth, innovation, research, and advocacy for non-acute providers. Many of Banks’ most notable achievements center on her work in supporting staff in obtaining R.N. licenses and continuing their post-graduate education. Banks herself obtained her Doctorate in Nursing Practice from the MGH Institute for Health Professions in 2019.

“I am thrilled to congratulate Maureen on this well-deserved recognition,” said Joanne Fucile, R.N., VP of Hospital Operations and Associate CNO at Spaulding Hospital Cambridge. “Her experience across the healthcare continuum allows her to understand the complexities of the system and innovate on behalf of her patients and her staff. Her incredible contributions to the healthcare community will leave a lasting legacy.”

In addition to her work at Spaulding, Banks is an active member of the community and an advocate for individuals with disabilities. She serves as a trustee for the Perkins School for the Blind, and has advocated to include disability in Spaulding and Mass General Brigham’s DE&I mission.

Healthcare Heroes Recognized at Annual Meeting

But now, post pandemic, the challenges are even greater, she said. “Without the adrenalin and incredible raw energy that we relied on for almost three years, we are watching nurses reevaluate their careers in the context of their emotional and mental health, the flexibility they desire, how safe they feel at work, and how satisfied they are with the care they are able to provide to their patients every single shift,” Gaden said. She impressed upon the gathering the need to reassess the profession, to embrace the fact that young nurses entering the profession are looking for flexibility in their work environments.

“Nurse leaders have a deep commitment and desire to make the world a better place for nurses,” Gaden said. “We want our staff to know that nurse leaders are their biggest advocates. And, of course, this is a challenge as we balance quality, safety, and nursing satisfaction with the financial pressures in our organizations … Our nursing departments need innovation, and creativity, and boldness. We need to respond to the issues that our nurses have told us are most important to them.”

MHA presented all hospital CNOs with the gift of a compass, symbolizing the direction they provide to their staff and the healthcare system.

The chairs of the House and Senate Ways & Means Committees at the State House, Rep. Aaron Michlewitz (D-Boston) and Sen. Michael Rodrigues (D-Westport) were presented with MHA’s Hero Award on Thursday.

The Health and Hospital Hero Award was created to recognize a public official(s) who has demonstrated outstanding advocacy on behalf of Massachusetts patients and healthcare providers.

“The financial support that you helped provide saved providers in this room from the brink,” said MHA President & CEO Steve Walsh. “You showed up and stood up when it mattered the most. You’ve always been compassionate, you’ve always been collaborative – no doubt. But this session was just different. You both were, in effect, caregivers. You literally made decisions in the people’s building that saved lives. When the chairs of Ways & Means, elected officials in a government office, are sharing the same mission as the caregivers in our commonwealth we are working as one for your constituents, for our patients, and for all of our loved ones that needed service in the commonwealth’s hospitals.”

Gov. Healey to Annual Meeting: “Number One Concern is Workforce”

“Boy, did you guys come together when this commonwealth needed you to and you saved lives,” the governor said.

“My number one commitment and concern is workforce,” she continued. “I know that the workforce situation is devastating right now. We have got to do all we can to recruit and train up as many people as possible, as quickly as possible.” She also endorsed building on the innovations that emerged during the pandemic such as the increased use of telehealth.

Of the complex problems facing the healthcare system, Healey said, “No state is better situated than Massachusetts, with the greatest collection of human capital, intellectual capital, and social capital to figure out a way forward and in doing so to change the lives of people and communities in this state, but also to lead this nation as we always have, especially in this [healthcare] space.”

Kate Walsh Appointed EOHHS Secretary

Kate Walsh, the CEO of Boston Medical Center Health System since 2010, has been selected by Governor Maura Healey to serve as the commonwealth’s Secretary of the Executive Office of Health & Human Services.

EOHHS is the largest secretariat in the state, consisting of 12 agencies – including the Departments of Public Health and Mental Health, among others – two soldiers’ homes, and the MassHealth program, which provides coverage to approximately 2 million residents. EOHHS’ approximately $27 billion budget is more than half of the state’s total fiscal year budget.

Healey said Walsh “will bring an innovative and compassionate approach to the office that centers the needs of patients and providers.”

MHA President & CEO Steve Walsh hailed the choice of BMC’s Walsh, saying that she is “an embodiment of everything our healthcare system strives to be, and she is an outstanding choice by the Healey-Driscoll Administration to lead EOHHS at this critical time for patients and caregivers. Kate has always been more than just a hospital leader. She is a tireless community advocate, a health equity champion, and a consensus-builder for a complex sector entering a transformational time.”

During her time at BMC, Walsh established the health system as a leader in health equity and in conducting research and groundbreaking medical practice to combat substance use disorder. BMC’s efforts in addressing social determinants of health, especially around housing and food insecurity, were successful and received national acclaim. The BMC Health System, in addition to containing the region’s largest safety-net hospital, also is made up of the WellSense Health Plan, and Boston HealthNet, a network affiliation of community health centers, among other components.

Walsh received her BA degree and master’s in public health from Yale University. With her appointment to EOHHS, Walsh resigns her position from the MHA Board of Trustees, which she led during 2017-18. Alastair Bell, M.D., the president of BMC Health System, will serve as its interim leader. Bell received his M.D. from the University of Oxford in England, a Master’s in Physiology from the University of Cambridge in England, and an MBA from Harvard Business School.

Labor Secretary Walsh Inspires Annual Meeting Gathering

“Being the secretary of labor for the United States of America, being the former mayor of Boston means the world to me – all those experiences mean so much,” he said. “Massachusetts has given me those experiences; many of those in this room have given me those experiences. And I thank you. I also want to thank you for making me proud. Because when I’m in a room in the White House with cabinet secretaries or the president, and I say that we have the best healthcare system in the world in Massachusetts, it’s not just words, it’s reality. So I want to thank you for that.”

HPC Issues Strong Policy Recommendations for Telehealth

The Health Policy Commission (HPC) last Wednesday issued a long-awaited report on telemedicine, which found, among other conclusions that telehealth helped provide equitable healthcare access during the pandemic, and that its use does not add to the overall cost in the healthcare system.

“We applaud the HPC’s recommendations, which are critical in allowing our patients, especially those who encounter barriers to care, to continue to have another viable and effective option to access their healthcare team,” said Dr. Ted Calianos, the president of the Massachusetts Medical Society (MMS). “The recommendations align with our legislative goal to ensure that healthcare providers are reimbursed equitably for meeting the same high-quality standard of care, no matter the modality, and recognizes the importance of equitable reimbursement as foundational to the sustainability of providers’ ability to offer care via telehealth to their patients and to continue to invest in technology and innovate in the digital health space.”

MHA, and the Massachusetts Telemedicine Coalition (tMED), joined MMS in applauding the HPC for its report and its strong policy recommendations that call for supporting continued access to telehealth services for patients. (The HPC report begins on page 52 of this slide deck.)

As underscored by the HPC’s report, virtual care has enabled greater patient engagement with their healthcare teams, which will help improve patient outcomes. However, stable reimbursement policies across payers and predictability for providers and patients founded on payment parity is essential to supporting sustained access to care via telehealth. Blue Cross Blue Shield of Massachusetts and Point32Health have both issued regressive, pre-pandemic policies that reduce payment by 20% for chronic care and primary care, effective July 1 and March 1, respectively. These policies are not consistent with the HPC’s recommendation for continued payment parity for primary care and chronic disease management services delivered via telehealth, including audio-only visits, which have proven to be critical for those communities that lack access to affordable broadband and digital literacy.

The MMS and MHA strongly support additional HPC recommendations that seek to reduce or eliminate telehealth administrative complexities and promoting standardization across all payers. These recommendations and others in the report are consistent with the tMED Coalition’s priority legislation, HD.3511/SD.1984, An Act Relative to Telehealth and Digital Equity for Patients, filed by Rep. Marjorie Decker and Sen. Adam Gomez.

“Our elected leaders have been instrumental in supporting the evolution of virtual care here in Massachusetts,” said Adam Delmolino, MHA’s director of Virtual Care and Clinical Affairs. “We hope that many of the report recommendations, along with legislation, will help provide a roadmap for the work that lies ahead. The coalition of telehealth advocates is especially focused on enhancing digital literacy for disenfranchised communities, making patient navigators a fully resourced part of the healthcare system, and making permanent many of the pilot programs that have expanded telemedicine’s reach.”

MassHealth to Patients/Providers: Member Redeterminations Coming

The federal government, effective April 1, is ending the continuous coverage protections it instituted during the COVID-19 pandemic. As a result, starting on April 1 and continuing for 12 months, all MassHealth members will need to renew their health coverage.

It’s a massive undertaking. MassHealth has begun working with advocates and providers to ensure that MassHealth members know of the requirement and the coverage options available to them.

Last week, MassHealth released this Eligibility Redetermination Outreach Toolkit. It contains messages, a poster, flyer, e-mail messages, social media copy, phone scripts and more. MassHealth is calling on all providers to share the messages in offices and community spaces and through their communications channels. The state will particularly stress during the first phase of the redetermination campaign the need for MassHealth members to update their contact information so that they are sure to receive renewal notices when MassHealth mails them.

For more information, visit this website for member, provider, and partner resources.

CHIA/MHQP Dashboard: Primary Care 8% of Healthcare Dollar

The Center for Health Information and Analysis (CHIA), in collaboration with Massachusetts Health Quality Partners (MHQP), has released a dashboard of metrics to monitor the health of primary care in the commonwealth.

The dashboard tracks metrics relating to finance (spending for primary care services), capacity (relating to workforce), performance (access and care), and equity (assessing inequities in the system). The data used varies on when it was produced, with some figures from 2019, some from 2020 when the pandemic resulted in delayed or cancelled primary care and preventive visits, while some is from 2021.

Among the volume of data shown in the dashboard are the following facts: primary care spending represents less than 8% of overall medical spending in the state and declined across all insurance categories from 2019 to 2020. The primary care workforce is aging; in 2020, 33.7% of primary care physicians in Massachusetts were aged 60 or older, an increase from 2018. In 2021, only 64% of Hispanic residents reported that they had a preventive care visit in the last year, versus 81% of White residents.

MHQP for the past 10 years has measured primary care performance and patient experiences. Last fall, CHIA selected MHQP to construct the dashboard. CHIA had already begun to track primary care expenditures, in response to then-Governor Baker’s legislation to increase primary care spending. By bringing MHQP onboard, CHIA was able to expand its data collection into capacity, performance, and equity.

“A strong primary care system makes us all better and makes the healthcare system better for all,” said Barbra Rabson, MHQP’s president and CEO. “As a public good, primary care deserves our collective support, protection, and investment – and the first step is measurement.” MHQP and CHIA say the dashboard, which will be updated regularly, provides the state with a factual foundation to drive policy initiatives and target resources to support primary care.

John LoDico, Editor