2 Bills: Behavioral Health & Medicaid

MHA's Priority Legislation is Filed

The legislature’s new session is underway and MHA, on behalf of hospitals across the commonwealth, has worked with legislative champions on filing a series of bills relating to MassHealth, behavioral health, healthcare quality and patient safety, and administrative simplification and cost reduction.
Over the coming weeks and months, Monday Report will feature a deeper look at specific bills from MHA’s priority legislation package that were filed prior to the Friday, January 16 early-file deadline. Heading up MHA’s list are two bills relating to behavioral health and federal Medicaid matching revenues that the state receives.
“An Act Expanding Coverage and Access to Behavioral Health Services”, filed jointly by Rep. Elizabeth Malia (D-Jamaica Plain) and Sen. John Keenan (D-Quincy) is comprehensive legislation developed in concert with the bill sponsors and a coalition of behavioral health providers. It advances numerous administrative fixes to minimize delays for patient access to behavioral health services, proposes innovative strategies to enhance care for difficult-to-place patients, and helps ensure appropriate resources are invested in the system.  
“An Act to Protect Healthcare Reform Funding”, filed by Rep. Jennifer Benson (D-Lunenburg) and Sen. Michael Rodrigues (D-Westport), establishes a dedicated trust fund to house the enhanced federal Medicaid matching funds that flow to Massachusetts under the Affordable Care Act. MHA and a broad coalition of healthcare stakeholders want to ensure that the federal funding is used to support low-income healthcare programs as Congress intended

In Memoriam: Dr. Michael Davidson

The death of Brigham and Women’s Hospital’s Dr. Michael Davidson Tuesday night from gunshots wounds saddened many beyond Dr. Davidson’s colleagues at the Brigham.  That a man of such talent, who dedicated his life to healing others, could be slain by someone within the walls of a facility that exists only to heal, not harm, seemed especially tragic.
By all accounts Dr. Davidson was a tremendously skilled surgeon, a good husband and father, and a valued friend to those who knew him.  Dr. Elizabeth Nabel, the president of Brigham and Women’s wrote to the hospital staff, “Dr. Davidson was a wonderful and inspiring bright light and an outstanding cardiac surgeon who devoted his career to saving lives and improving the quality of life of every patient he cared for. It is truly devastating that his own life was taken in this horrible manner.”

Nearly all hospitals in Massachusetts – not just the large academic medical centers – have held “active shooter” preparedness drills, in which staffs work with local police departments, their own security staffs, and other first responders to deal with possible incidences of violence – especially those involving members of the public wielding guns. Boston Police praised the team at the Brigham for its response to the handgun violence within its doors.

Quality Corner: MetroWest's Readmission Intervention Strategies

In 2011, MetroWest HomeCare & Hospice, in partnership with MetroWest Medical Center, initiated a strategic and evidence-based effort to reduce their emergent care visits and acute care hospitalization rates.

The effort began with the formation in November 2011 of MetroWest’s Re-Admission Intervention Strategy Council (RISC).  The RISC includes representatives from management, nursing, rehabilitation, palliative care, and a heart failure nurse specialist.  In addition, RISC invites specific expertise – for example, social worker, wound nurse, physician specialists – when needed to address particular issues. The Council took a multi-disciplinary approach to reducing unnecessary re-hospitalizations, improving quality of care and optimizing patient outcomes.  In the beginning, RISC met every other week and eventually was decreased to a monthly meeting.  Often special projects or educational programs require additional time of some RISC members.

Together these efforts have proven successful in reducing overall acute care hospitalization rates.  In June 2012, only six months into RISC, MetroWest Home Care’s readmission percentile ranked 46th in the state and 55th in the nation, according to CMS’s Home Health Compare and CASPER reporting system. In May 2013, after all RISC initiatives had been implemented, MetroWest was ranked in the 4th percentile for the state and the 6th percentile for the nation.  These numbers have been maintained.

The goals of RISC include:
• Use data collection and analysis to identify any trends in hospital transfers;
• Increase team awareness of patients who return to the hospital, especially repeat visitors;
• Use of Case Conferences and Plan of Care modifications to keep patients at home;
• Reduce hospital re-admissions and improve patient quality outcomes.

To identify trends, RISC developed a user-friendly data collection tool tracking patients transferred to the hospital....

To read the rest of this story, and other quality improvement success stories at Massachusetts hospitals, please click here.  

Boston Hospitals Cut Energy Use by 6%

A recent report by the Boston Green Ribbon Commission's Health Care Working Group (GRC-HC) – under the coordinating umbrella of Health Care Without Harm (HCWH) – shows that Boston hospitals have cut their energy use by 6% over the last three years, despite expanding their real estate footprint, patient care, and encountering more extreme weather. Read the full report here.

The report analyzed more than 18,000 energy and greenhouse gas (GHG) records covering 24 million square feet of Boston hospitals. The 6% reduction in energy use is equal to eliminating the annual GHG emissions of 7,486 passenger vehicles.

Massachusetts General Hospital reached 35% GHG reductions in 2014; Boston Medical Center is targeting a 45% reduction by 2020; and Brigham and Women's Hospital is committed to reaching 35% by 2020. According to HCWH, cost savings are conservatively estimated at $11.9 million.

Kate Walsh, co-chair of the GRC-HC and president and CEO of Boston Medical Center said, "Individual hospitals and the sector are making great progress, demonstrating cost savings. Reinvesting the savings in more and better clinical care, in research and in more energy efficiency is critical to maintaining our momentum.”

The Boston Green Ribbon Commission is a group of business, institutional and civic leaders in Boston supporting the implementation of the city’s Climate Action Plan. Health Care Without Harm works to make the healthcare sector “ecologically sustainable.”  Health Care Without Harm, along with other similar organizations, created the Healthier Hospitals Initiative (HHI), of which MHA is a supporting organization. While HHI has a total of six “challenge areas” that hospitals can pursue, MHA has partnered with the Initiative to promote a statewide hospital focus on two specific challenge areas: to reduce energy use; and to purchase and serve locally sourced, healthier foods that have less impact on the environment.

AG Healey Focuses on Drug Crisis

Saying that as Attorney General she is the “people’s lawyer”, AG Maura Healey delivered her inaugural address in Boston’s Faneuil Hall on Wednesday, and said that among her priorities would be combatting a heroin and prescription drug crisis, and helping residents with “rising healthcare costs and a market they can’t understand.” “We will work to improve our prescription monitoring program, educate prescribers, go after drug traffickers and pill mills, and expand access to recovery and treatment programs,” Healey said. Late last year, MHA created a Substance Abuse Prevention and Treatment Task Force to address the opioid crisis from the hospital/prescribing side. The Task Force is expected to release the first of its recommendations shortly and has pledged to work with Healey, as well as with Governor Baker on this priority issue. 

MassHealth has New Quality Reporting URL for P4P

The state has informed quality improvement specialists at hospitals of a new web-friendly URL for the MassHealth Quality Exchange (MassQEX). The MassQEX is used for the electronic submission of measures data required as part of the MassHealth Acute Hospital Pay-for-Performance (P4P) quality reporting requirements. The new URL is: www.mass.gov/masshealth/massqex; the Executive Office of Health and Human Services recommends that hospitals share it among staff involved in quality reporting.


Michael Gustafson, MD, MBA has been named as president of Brigham and Women’s Faulkner Hospital (BWFH), effective immediately.  He had been serving as the hospital’s COO since 2011. Prior to joining BWFH in 2011, Dr. Gustafson served in senior leadership roles at Brigham and Women’s Hospital for more than a decade, most recently as senior vice president for clinical excellence.  He completed his medical degree at West Virginia University, general surgery residency at Brigham and Women’s Hospital, and a surgical research fellowship at Massachusetts General Hospital, and later received his MBA from Harvard Business School in 1999.

Gov. Baker has named Louis Gutierrez of Exeter Group as new executive director of the Massachusetts Health Connector. Gutierrez has extensive CIO experience in both state government and the healthcare sector ... Baker also named Daniel Tsai as director of MassHealth and elevated the position to Assistant Secretary for MassHealth under EOHHS Secretary Marylou Sudders. Tsai currently serves as a Partner in McKinsey & Company’s Healthcare Systems and Services practice, co-leading the firm’s Medicaid service line.

Under the new State Senate committee assignments announced last week by Senate President Stan Rosenberg (D-Amherst), Sen. James Welch (D-Springfield) maintains the Senate chairmanship of the Joint Committee on Health Care Financing Committee; Sen. Karen Spilka (D-Ashland) was appointed chairwoman of the Senate Ways and Means Committee; Sen. Jason Lewis (D-Winchester) was named Senate chairman of the Joint Committee on Public Health; Sen. James Eldridge (D-Acton) was named Senate chairman of the Joint Committee on Financial Services; and Sen. Jennifer Flanagan (D-Leominster) was named Senate chairwoman of the Joint Committee on Mental Health and Substance Abuse. Flanagan will also chair a Special Senate Committee on Opioid Addiction, one of five special Senate committees created by the new Senate President. 

Understanding How Data can Transform Your Organization
and Help Manage Populations 
Wednesday, February 11, 2015, 9 A.M. - 2 P.M.
MHA Conference Center at Executive Park, Burlington, Mass.

The stakes have never been higher for healthcare. With costs on the rise, legislative uncertainty and changing payment models, providers and their finance leaders need to be on top of their game and implement the needed business strategies to address these challenges. Using healthcare analytics is fast becoming a proven method for providers to enhance their operations in many ways. Join us at this special program, looking at emerging best practices for provider organizations to better manage populations, reduce variation, and realize cost savings. Visit here for more details, costs, and registration information.

John LoDico, Editor