Massachusetts Health & Hospital Association 
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> Senate Ways & Means Budget
> INNOVATION SERIES: Hebrew SeniorLife
> Addressing Prior Auths
> HPC on BH
> Building Apprenticeships
> Transition
> National Hospital Week
MONDAY REPORT
Senate Ways & Means Budget
The Senate Ways & Means Committee released its fiscal year 2027 state budget proposal last Tuesday and debate on the budget will begin next week. The Senate’s proposal reflects an increase of $2.25 billion, or 3.7%, over the FY2026 General Appropriations Act.
The $63.3 billion spending plan largely mirrors the already-completed House budget, although it differs in key areas such as school funding, housing zoning reforms, and, most importantly to the hospital community, its funding of the Health Safety Net.
In the budget it passed in late April, the House transferred $37.5 million from the Commonwealth Federal Matching and Debt Reduction Fund to the Health Safety Net Trust Fund. That money is eligible for a federal match, meaning the House provided $75 million in additional relief to the Health Safety Net in FY2027. This additional transfer is not in the Senate Ways & Means budget and MHA will be advocating for similar transfer language through the amendment process.
In FY2027, the Health Safety Net is affected by the 36,000 individuals who lost ConnectorCare Type 1 coverage as of January 1, 2026 – all of whom earn less than the poverty level and therefore are eligible for the Health Safety Net. The situation worsens in FY2028. With as many as 300,000 people in Massachusetts expected to eventually lose coverage as a result of the One Big Beautiful Bill, safety net shortfalls (which hospitals alone must cover) could reach as much as $900 million in subsequent years, pending relief or changes to the program.
The Senate budget funds a wide variety of health programs, from the $1.1 billion to support Department of Public Health initiatives relating to pediatric palliative care, chronic disease prevention, HIV/AIDS treatment and prevention, and more; to funding for a series of programs through the Department of Mental Health and the Bureau of Substance Abuse Services. The Senate proposal also devotes $22.74 billion to MassHealth, which is slightly higher than the House’s allotment, and is the largest single component of the budget.
Massachusetts is a State of Bold Firsts
Home to the nation’s first public school, the first subway system, the first lighthouse and public school, the birthplace of basketball, and even the first chocolate chip cookie, the commonwealth has long been a place where new ideas take shape, endure, and seed innovations across the globe.
Nowhere is that legacy more prominent than healthcare. From lifesaving clinical advancements to innovative models of care delivery that touch every neighborhood, Massachusetts hospitals and health systems always have led the way.
For 90 years, the Massachusetts Health & Hospital Association has stood alongside our member organizations as they advance a legacy of innovation, driven by a shared commitment to improving patient lives, empowering caregivers, and strengthening communities.
In recognition of these innovations and National Hospital Week (see story below), MHA has compiled stories from hospitals and health systems across the state, and will feature the stories periodically in Monday Report.
Hebrew SeniorLife: Strength at Every Age
In the 1990s, it was widely believed that strength training was dangerous for older people. While some research existed on strength training in healthy people in their 60s and 70s, there were almost no studies on significantly older adults with frailty in long-term care settings. Hebrew SeniorLife’s research institute aimed to test that widespread belief through two studies led by Dr. Maria Fiatarone Singh. The studies explored the effects of strength training on long-term care residents in their 80s and 90s. The study results did more than challenge beliefs — they affected how people view aging and strength. According to a pilot study, over just eight weeks of training, nine residents aged 87 to 96 showed an average strength increase of 174%. Researchers didn’t observe the cardiovascular problems that doctors feared. A follow-up study in the New England Journal of Medicine in 1994 saw tremendous gains in those doing progressive resistance training, including a 113% average increase in leg strength, improved walking speed, stair climbing ability, and spontaneous physical activity.
News on Prior Authorizations: CMS & UHC
The Centers for Medicare and Medicaid Services (CMS) last week announced a general plan – but not specifics – to bring together providers and payers, along with the tech community, to create an electronic prior authorization system.
In a letter entitled Moving Prior Authorization into the 21st Century, CMS Administrator Dr. Mehmet Oz noted the inefficiency of paper-based prior authorizations and wrote, “It is way past time to axe the fax, kill the clipboard, and put patients over paperwork.”
In January 2024, CMS issued the Interoperability and Prior Authorization Final Rule that committed select payers to improve the electronic exchange of health information and prior authorization processes for medical items and services by January 1, 2027.
Last week’s announcement is meant to bring other parts of the healthcare continuum to the table to make the electronic transfer of information more robust. That work will entail embedding electronic prior authorization directly into electronic health records (EHRs). The move to streamline approval processes is generally a goal of the entire healthcare sector as numerous studies have shown that red-tape roadblocks are a leading cause of rising healthcare costs. But upgrading technology and synching various systems has historically proved to be a very difficult – and very expensive – task.
In other prior auth news from last week, UnitedHealthcare, the large national insurer that Massachusetts hospitals consistently rate as one of the most complicated payers with which to work, announced that it would cut 30% of its prior authorization requirements by the end of the year. In a statement, the insurer said the procedures affected include select outpatient surgeries; some diagnostic tests, such as echocardiograms; some outpatient therapies; and some chiropractic care. A full, more detailed list will be posted in the future, United said.
HPC Issues Report on Behavioral Health Services
The Health Policy Commission (HPC) last week issued a report entitled Examination of Payments for Behavioral Health Care Services that found, among other conclusions, that master’s level providers delivered the majority of non-medical psychotherapy services but often received the lowest reimbursement for those services, and that MassHealth in many instances is doing a better job reimbursing for behavioral health (BH) services than commercial health insurance companies.
The 56-slide report found that “commercial payers reimbursed master’s-level clinicians at about 66% the rate of physicians. In contrast, MassHealth paid master’s-level clinicians at 93% the rate of physicians for psychotherapy,” and that commercial rates for psychotherapy grew more slowly for inflation. “As demand increases, if the prices for [behavioral health, BH] care do not keep pace with wages and the economy, then lower-cost BH services may become too costly for some organizations to provide.”
In its recommendation section, the HPC called on the legislature to set a minimum payment level for commercial payers, equivalent to 150% of the Medicare rate for office and telehealth BH services. And that “Both commercial payers and MassHealth should adjust payments to BH providers and facilities in alignment with reasonable and known cost increases, including cost of living and provider wages.”
Currently, Massachusetts inpatient psychiatric payments are not based on the costs of providing these services. The HPC’s report recommends assessing the “adequacy of BH rates, and report[ing] on the relationship between commercial rates, cash-pay rates, and BH workforce salaries.” The report also recommends that the legislature direct the HPC “to convene a task force on the cost of delivering BH services across care settings. The task force should develop recommendations for assessing whether payer rate methodologies and payment growth are aligned with reasonable and known costs, including price inflation, cost of living, and provider wage increases.”
Massachusetts One of 10 States Chosen for Apprenticeship Grant
Massachusetts is one of 10 states chosen to be part of “Apprenticeship America,” funded by the U.S. Department of Labor with support from the Colorado Department of Labor and Employment, aimed at building the population of apprentices in a variety of fields.
The 10 states will each receive a $200,000 grant and guidance from the non-profit group CareerWise on how to build employer-led registered apprenticeship systems for youth. In her third State of the Commonwealth address, Governor Maura Healey set the goal of registering 100,000 new apprentices by 2036 in fields such as construction, healthcare, tech, advanced manufacturing, and education.
Transition
MHQP has appointed Jane Barrow as its new CEO, effective June 1. She will succeed Barbra Rabson, who has led the organization for the past 28 years. Barrow most recently served as associate dean and executive director at Harvard School of Dental Medicine.
National Hospital Week
National Hospital Week 2026, running from May 10–16, provides an opportunity to remind the public and policymakers of how important hospitals, health systems, and healthcare workers are to individuals, families, communities, and the economy. The healthcare ecosystem in Massachusetts generates $94 billion in annual economic activity and supports more than 452,000 jobs across sectors statewide. Massachusetts hospitals and health systems also devote more than $4 billion annually to provide subsidized care for low-income patients and to fund programs within their communities that improve health outcomes.
As for the national celebration itself, Hospital Week dates back more than 100 years. In 1921, President Warren Harding established National Hospital Day on May 12 – chosen to honor Florence Nightingale’s birthday. The idea came from Matthew Foley, editor of Hospital Management journal, who wanted to rebuild public trust in hospitals after the 1918 flu pandemic. Fifteen years later in 1936, a group of forward-thinking leaders in Massachusetts created MHA, which is celebrating its 90th anniversary this year.