INSIDE THE ISSUE
Initial HPC Analysis: Telehealth Doesn’t Increase Utilization or Spending
The Health Policy Commission (HPC) last Wednesday released the preliminary results of its inquiry into telehealth’s access, usage, and costs since the pandemic began in early 2020, and concluded that the growing use of telemedicine is not a driver increasing total healthcare costs.
Telehealth blossomed during the pandemic as patients stayed away from medical facilities due to COVID-19. In January 2021, Chapter 260 of the Acts of 2020 was signed into law, putting in place a framework for coverage and reimbursement policies for telehealth services.
The HPC’s preliminary report found that two-thirds of all telehealth visits in 2020 were for mental health conditions, and that telehealth use was higher for those in communities that were more urban and had a high level of internet access.
In making their presentation last Wednesday, HPC staff noted that telehealth was “substitutive” rather than “additive.” That is, patients and providers do not use telehealth over and above in-person care.
“The HPC’s preliminary data confirms what providers have been saying for years: telehealth use does not appear to increase total utilization or spending,” says MHA’s Director, Virtual Care & Clinical Affairs, Adam Delmolino. “We appreciate the fact that the HPC’s data validates virtual care – a convenient tool that patients and providers can use and that can improve patients’ quality of life. With telehealth, patients don’t pay for the gas, tolls, and parking associated with in-person appointments. Telehealth reduces time wasted in waiting rooms, and the lost productivity to employers when a worker takes time off for a health appointment. We look forward to the final report from the HPC mandated by Ch. 260, which will provide policy recommendations on key issues, including reimbursement parity for all telehealth services.”
The findings align with the ongoing advocacy of MHA and the tMED Coalition. They support continued insurer reimbursement of telehealth on par with in-person visits for primary care and chronic disease managements services; that payment parity is currently scheduled to end at the conclusion of this calendar year.
Health Equity Efforts Underway Throughout Healthcare
Hospitals and the healthcare community as a whole continue to advance efforts to apply diversity, health equity, and inclusion principles into how care is provided, the healthcare workforce is built, and interactions with service areas are strengthened. MHA, through its board-level Standing Committee on Diversity, Health Equity and Inclusion, and Director of Health Equity, is helping to coordinate those efforts across the state. MHA and its membership have also coordinated with the State’s Executive Office of Health & Human Services over the past year-plus to create within the recently approved five-year Medicaid waiver an innovative program that hold providers accountable for health equity improvements. The following are just a few recent developments both within and outside of the healthcare community to sharpen the DHE&I focus.
Boston Children’s, Dana-Farber Fund Growth Capital Fund
To improve the health of communities, residents need stable housing, access to nutritious food, safe streets, and more. An overall strategy to address those factors and others is to improve the wealth of communities by supporting and growing local businesses.
Recently Boston Children’s Hospital and Dana-Farber Cancer Institute joined BayCoast Bank to create a $1 million Massachusetts Small Business Growth Fund that will provide capital to established businesses with a strong growth plan and that are owned by people of color.
The fund will be administered by the community-development group LISC Boston (Local Initiatives Support Corporation). LISC will invest in businesses with revenues between $250,000 and $3 million that have been operating for at least two years and that have the ability to deploy capital for business improvement and growth. Investment amounts will be sized based on revenue potential, but are expected to range from $50,000 to $250,000. Businesses located in economically-disadvantaged communities will be preferred.
“Our collaboration with LISC Boston is an innovative way for a hospital to help promote the health and well-being of families through expanding resources and developing wealth building opportunities in our community,” said Shari Nethersole, M.D., VP for Community Health and Engagement at Boston Children’s Hospital.
Magnolia Contreras, VP of Community Health at Dana-Farber agreed. “Part of our mission is to reduce the burden of cancer,” she said. “This means that an essential component of our work is addressing the social determinants of health. We are doing it in the health and housing space and now we are pleased to participate in addressing the economic issues that contribute to poor health.”
Entrepreneurs of color seeking capital may request further information by emailing LISC at LISCFinancingMA@lisc.org.
Kraft Family Donation to MGH Targets Equity
New England Patriots owner Robert Kraft and The Kraft Family Foundation last week donated $50 million to Massachusetts General Hospital (MGH) to address healthcare disparities caused by race, ethnicity, geography, and economic status.
According to an MGH media release, the Kraft gift will support a permanent Robert K. Kraft Endowed Chair in Diversity, Equity and Inclusion addressing health disparities in clinical care at MGH and outside of the hospital’s walls. The chair will be held by the medical director of the Comprehensive Sickle Cell Disease Treatment Center at MGH. The gift will also further endow the Kraft Center for Community Health, established in 2011, to improve health outcomes for disadvantaged populations. Kraft funding will also allow MGH to expand the Mass General Blood Donor Center to, among other goals, become “the primary source of blood for patients treated at MGH” and to create “a diverse donor population to support the care of patients with sickle cell and other blood disorders that primarily affect minority populations.” Kraft’s son Jonathan is chair of the Mass General board of trustees and president of the Kraft Group.
DPH Needs Volunteers for Black Birth Study
Massachusetts DPH, in coordination with Tufts University, University of California San Diego, and Accompany Doula Care, is recruiting doulas, parents, and OB/GYNS for participation in the Black Birth Equity Study. Its goal is to learn about how doulas can support pregnant, birthing, and postpartum people to improve perinatal mental health and disparities experienced by Black women. To be eligible to participate, you must be actively providing support to clients who are receiving their healthcare within greater Boston. The study is especially interested in doulas who are Black and/or serve clients from diverse backgrounds. The recruitment will run through mid-November. If you’re interested in participating, or have any questions about the study, please email the team at firstname.lastname@example.org.
Ongoing Efforts Outside of Massachusetts
A hospital is extending lessons learned in the economic equity space to address severe workforce shortages and diversify its staff. In Connecticut, UConn Health will fill 5% of entry-level positions with previously incarcerated people in the next three years under the One Million Jobs Campaign by the Connecticut NAACP. The UConn Health medical center will initially place people in clerical jobs, and building and grounds maintenance, but the plan is to help them with “skill set training” and provide them a pathway for future internship opportunities.
Moderna/Pfizer Bivalent Vaccine Approved for Children
Last Wednesday, the U.S. Food and Drug Administration (FDA) revised its existing emergency use authorization to Moderna to allow the company to provide its COVID-19 bivalent vaccine to children aged 6 and over. On the same day, the FDA also approved Pfizer’s bivalent vaccine to children aged 5 and over.
Both single-booster vaccine can be administered at least two months after the children’s’ primary or booster regimen.
“Since children have gone back to school in person and people are resuming pre-pandemic behaviors and activities, there is the potential for increased risk of exposure to the virus that causes COVID-19,” said Peter Marks, M.D., director of the FDA’s Center for Biologics Evaluation and Research. “Vaccination remains the most effective measure to prevent the severe consequences of COVID-19, including hospitalization and death.”