Massachusetts Health & Hospital Association 
INSIDE THE ISSUE
> Walsh to Lead AHA
> Building the BH Workforce
> Op-Ed on Workplace Violence
> Worsening Hospital Financials
> Medicaid Work Rule Opposed
> Medical Debt Reporting
> AHA Quality Prize
> Transition
MONDAY REPORT
MHA’s Steve Walsh to Lead AHA
Steve Walsh, who has led MHA since November 2017, has been named the President and CEO of the American Hospital Association, effective this fall. He will remain fully engaged in his role at MHA until that time.
AHA represents nearly 5,000 hospitals, health systems, networks, and other provider groups across the United States that employ more than 270,000 affiliated physicians and two million-plus nurses, among other workers.
In announcing the appointment, Marc Boom, M.D., chair of the AHA Board of Trustees and president and CEO of Houston Methodist, said, “Steve is a proven healthcare leader, innovator and accomplished advocate for healthcare improvement, who understands both the challenges facing hospitals and the opportunities ahead. Throughout his career, he has demonstrated an ability to bring people together, build consensus and advance meaningful solutions on behalf of patients, caregivers and communities.”
Anne Klibanski, M.D., the president and CEO of Mass General Brigham and current chair of the MHA Board of Trustees, said, “I am thrilled that healthcare systems across the country will soon benefit from Steve’s depth of knowledge and commitment to patients, communities, and training for the next generation of healthcare providers. We are a strong healthcare state because of the relentless energy, deep understanding of our hospitals and health systems’ value, and expert consensus-building that he brings to this job every single day. That sense of purpose will make him a phenomenal choice to lead our hospitals at the national level.”
In his time as MHA’s leader, Walsh led the association’s response to major crises, including COVID-19 and the Steward Health Care bankruptcy. Among many other achievements, he helped unite hospitals and organized labor (MNA/1199SEIU) around a consensus piece of legislation to address workplace violence (see related story below); engineered creative financing to close care disparities through the current Medicaid waiver and hospital assessment; launched the Massachusetts Payer-Provider Partnership (MP3), a novel organization that brings health systems and insurers together to create shared solutions around access and affordability; brought the hospital voice to the Health Policy Commission; and oversaw campaigns to build the workforce and to create the Healthy Work Environment Academy, which places frontline nursing teams at the center of problem-solving.
The MHA’s Immediate Past Chair of the Board, Mike Lauf, the president & CEO of Cape Cod Healthcare, enjoyed a close working relationship with Walsh as they navigated through a series of thorny financial and regulatory challenges during Lauf’s reign as board chair. He said of Walsh, “In nearly a decade of leading MHA, Steve has steered local hospitals and health systems through some of the most challenging issues – and ambitious opportunities – in their history. Through it all, he has led with the conviction that we are at our best when we are thinking big and setting a standard for others to follow. He has been at the center of our first-in-the-nation efforts to support the workforce, close care disparities for patients, and break boundaries between providers, payers, policymakers, and advocates. Steve is a special leader for society’s most essential sector. We know his leadership will help take American healthcare to new heights.”
His colleagues at MHA credit him for redefining how the association undertook its mission, hiring and mentoring diverse talent, and creating a non-siloed culture where staffers stepped up, encouraged to follow their instincts as they worked hard for the membership and for a boss that they knew always “had their backs.”
Walsh is also credited with building strong coalitions between hospitals and other components of the healthcare system. “He has always been the most prepared in the room, the most willing to engage in difficult conversations, and the person most vested in delivering access and quality for everyone,” Michael Curry, president and CEO of the Mass. League of Community Health Centers told the Boston Globe.
“Leading MHA has been the honor of my lifetime, and it has everything to do with the character of our people: from our board and staff to policymakers to caregivers,” Walsh said. “I am enormously proud of what we have accomplished together over the course of this decade and how that united work is changing the lives of patients. I am grateful for the MHA board’s belief in me, knowing the best is still yet to come for this association and the communities it serves.”
Before his leadership at MHA, Walsh was president and CEO of the Massachusetts Council of Community Hospitals. As a State Representative for the 11th Essex District, he was House chair of the Health Care Financing Committee, where he oversaw the drafting and passage of the commonwealth’s 2012 landmark healthcare payment and delivery reform law, Chapter 224. He was also a member of the legislative conference committee that drafted Chapter 288 of the Acts of 2010, the commonwealth’s small business healthcare legislation.
The MHA Board has named Michael Sroczynski, president of the Hospital Association of Rhode Island and MHA general counsel, as interim president & CEO for the association, effective upon Walsh’s departure this fall.
$1 Million for Behavioral Health Workforce Development
The behavioral health workforce in Massachusetts, which is facing shortages from patient sitters to psychiatrists, received some good news last week thanks to the Massachusetts legislature and assisted by MHA.
First, MHA coordinated the distribution of $500,000 in money that the legislature included in the FY2026 state budget and that was earmarked for building a pipeline of culturally, ethnically, and linguistically diverse mental health professionals between Massachusetts colleges and acute care hospitals across the state. While the funding was appropriated last July, it was not available until this May, at which time the state asked MHA to step in and help distribute it. What followed was a quickly formed Request for Proposals process, followed by application reviews, and the distribution of funds.
MHA received more than 10 proposals. Dr. Solomon Carter Fuller Mental Health Center, Cape Cod Healthcare, Merrimack Health, Franciscan Children’s, Cambridge Health Alliance, Berkshire Health Systems, Middlesex Community College, North Shore Community College, William James College, and Mass Bay Community College were chosen to receive funding to implement innovative workforce initiatives. These projects will expand training opportunities, hire new trainees, provide stipends supporting more than 100 students pursuing behavioral health degrees and certifications, and deliver wraparound services – such as transportation and childcare assistance – to help students successfully complete their education and transition into high-demand behavioral health careers.
“Thanks to the legislature and the Healey-Driscoll administration – as well as the hospitals, health systems, and colleges that are committed to building the behavioral care workforce – we will be able collectively to make significant progress in helping students enter the field,” said Leigh Simons, MHA’s vice president of policy and regulatory affairs. MHA’s Amy Smalarz, executive director of the Center for Healthcare Education & Professional Development, helped facilitate the distribution of the state money. “The good news is that the state’s commitment to this important project will likely continue.”
Simons was referring to the inclusion of another $500,000 in the legislature’s consensus FY2027 budget released last week. That budget language identifies MHA as the administrator of the recent tranche of workforce development funding.
Op-Ed On Workplace Violence Legislation Appears in Globe
In a Boston Globe op-ed entitled Every 36 minutes a healthcare worker is assaulted (a subscription may be required), Cari Medina, executive vice president of 1199SEIU; Katie Murphy, president of the Massachusetts Nurses Association; and MHA’s Steve Walsh called on the Massachusetts legislature to pass a workplace violence prevention bill before the formal session ends July 31.
H.4767, An Act Requiring Healthcare Employers to Develop and Implement Programs to Prevent Workplace Violence, passed unanimously in the House last November and is pending in the Senate.
“After years of competing yet similar legislation, our organizations — representing hospitals and health systems, nurses, and other front-line caregivers — have come together to champion a single proposal that would address safety and violence prevention in local healthcare facilities,” Medina, Murphy, and Walsh wrote. “This consensus legislation extends far beyond what one organization or care team can accomplish on their own.”
The bill, among other elements:
- Requires healthcare facilities to establish a standardized framework for violence prevention and response, constructed in collaboration with employees and labor representatives;
- Creates new state-level reporting procedures;
- Strengthens penalties for offenders who “knowingly and intentionally” assault a healthcare employee;
- Recognizes that individuals in a behavioral health crisis may act violently without intent, and identifies ways to ensure appropriate treatment for them; and
- Entitles victims to paid leave and legal support following a violent incident.
The labor and hospital authors say the bill “would send a powerful message that entering a healthcare facility is no different than entering an airport, where there are hard-line expectations around threatening or putting one’s hands on an employee.”
Hospital Financials Dip … Again
The Center for Health Information and Analysis (CHIA) has released its latest quarterly hospital financial report that showed the statewide hospital median operating was 1.1% through March 31, 2026 – a decline of 0.4 percentage points from the same time in FY25. Forty percent of hospitals reported negative operating margins.
Hospital health systems, which include affiliated physician organizations, had a median operating margin of negative -2.1% – a decline of 2.3 percentage points from the previous year. Seventy percent of hospital health systems reported negative operating margins.
While the numbers are disturbing and have been for some time, the financial outlook is expected to sour even more. The deepest impacts from the One Big Beautiful Bill coverage losses are yet to occur, which will place enormous pressure on the already-hobbled Health Safety Net. Restrictions on state directed payments, curtailment of 340B drug pricing benefits, and even the state’s recent proposal to rewrite the RFA – the main Medicaid contract Massachusetts has with hospitals – all are eroding critical funding sources. Add to those concerns the fact that, on average, patients are spending 10% longer in hospital beds than they were in 2019, and that hospitals receive little to no additional payment for accommodating these patients, leading to enormous financial losses.
“While CHIA’s quarterly report is a troubling pulse-check on hospitals’ financial wellbeing, we know the most daunting days are still to come,” said Dan McHale, MHA’s senior vice president of healthcare finance & policy. “Seventy percent of hospital health systems are already operating in the red due to a dangerous confluence of cost pressures – including unsustainably high fixed expenses, a flailing health safety net, and a rise in patients requiring more intensive services. Those challenges will only compound as major changes to Medicaid coverage and financing cause hospitals’ limited resources to be stretched even further.
“These factors live at the center of the affordability equation our state is rightfully attempting to solve,” McHale continued. “This is a valuable – and urgent – opportunity for Massachusetts to consider those pressures as we work to make healthcare more affordable while maintaining a strong system for communities across the commonwealth.”
Mass. Joins 25 Other States and D.C. in Opposing Medicaid Work Rule
Massachusetts Attorney General Andrea Joy Campbell joined AGs and governors from 24 other states and the District of Columbia in filing a lawsuit last week against portions of the Trump administration’s regulation implementing the Medicaid work requirements included in the One Big Beautiful Bill Act (OB3).
OB3’s Medicaid work requirements apply generally to non-pregnant individuals between the ages of 19 and 64, who are not enrolled in Medicare or a state’s mandatory Medicaid plan. To receive Medicaid coverage, these individuals must show they work no less than 80 hours per month, although there are certain exceptions, hardship exemptions, and other workarounds. The AGs in their suit note that Congress specifically excluded from the work requirements individuals who are “medically frail,” including, among others, people who are blind, disabled, with a substance use disorder, or with a “serious or complex medical condition.”
“Congress’ categorical exclusions represent a crucial vehicle for protecting individuals who would otherwise be disproportionately burdened by new work requirements,” the AGs wrote.
Between passage of OB3 in July 2025 and the release of the work requirement interim final rule on June 1, 2026, the Centers for Medicare and Medicaid Services (CMS) held many information sessions with state Medicaid agencies to discuss timelines, its thoughts on implementation, and other complexities surrounding the rule, including what “medically frail” meant. But when the proposed regulation was published June 1, the AGs say the states were blindsided by a requirement that they would have to find that a “medically frail” patient was “significantly impaired” from working. To do so, the states informed the administration, would require them to build completely new verification systems over and beyond systems that analyzed medical claims or that relied on self-attestation.
But more importantly, the AGs say, adding new requirements to the “medically frail” exclusion – namely a requirement of “significant impairment” – goes against what Congress intended, which violates the Administrative Procedures Act. Plus the regulation does not detail how states are supposed to determine “significant” impairment.
The suit, which was filed in the United States District Court for the District of Massachusetts, asks the court to block provisions of the final rule. States are expected to begin implementing the work requirements on January 1, 2027.
Regulation Would End Medical Debt Reporting to Debt Collectors
Following up on a promise she made at her State of the State speech in January, Governor Maura Healey last week announced new proposed regulations from the Department of Public Health (DPH) that would prohibit any healthcare provider from reporting any portion of a patient’s medical debt to a consumer reporting agency.
The governor announced the new regulations at a media conference last Tuesday at Health Care For All’s offices in Boston.
State House News Service reported Healey as saying, “Medical debt isn’t a sign of poor financial health. It isn’t a sign that you’ve mismanaged your finances. Medical debt happens because bad stuff happens. You get a disease, you get a diagnosis, you get hurt, and medical bills pile up.”
Under the proposed regulation – 105 CMR 95.00: Requirements Applicable to All Health Care Facilities and Providers Licensed by the Department of Public Health – all contracts executed on or after January 15, 2027, between debt collectors and healthcare providers, must contain a provision that prohibits the reporting of any portion of medical debt to a consumer reporting agency. Any contracts executed prior to January 15, 2027, and extending past April 15, 2027, must be terminated or amended to include a provision prohibiting medical debt reporting. The proposed regulations allow for a waiver if the healthcare facility or provider can document that compliance would cause the healthcare facility or provider undue hardship. The new proposals are in addition to existing debt collection regulations relating to the Health Safety Net, which require hospitals to complete a series of steps, including screening for Health Safety Net or financial assistance eligibility, before pursuing collections.
A public hearing on the proposed regulations is scheduled for Monday, July 27.
Apply For AHA’s Top Quality Prize
The American Hospital Association is accepting applications through Tuesday, August 18 for the 2027 Quest for Quality Prize, which honors hospitals and health systems committed to leadership and innovation in improving quality and advancing health. Honorees provide access to safe and patient- and family-centered care, partner with organizations and agencies to improve the health status of their communities, and develop new and innovative models of care. The last Massachusetts recipient of the prize was Beth Israel Deaconess Medical Center in 2013. Awards will be presented to one winner and up to two finalists at the 2027 AHA Leadership Summit, July 18-20, 2027, in San Diego.
Transition
Brown University Health has appointed Julie Abilheira, R.N., as president of its Massachusetts facilities, Morton Hospital in Taunton and Saint Anne’s Hospital in Fall River, which are both members of MHA. Abilheira was most recently senior vice president of medicine, cancer, radiation oncology, and dermatology at Brown University Health. She received a BSN from the University of Rhode Island and her MS in Healthcare Administration from Salve Regina University. The health system also announced that Heidi Taylor will now serve as COO and CFO at the two Massachusetts hospitals.