Helping Out in Texas, A Busy Month of Advocacy, and more...

MHA Coordinates Nurse Airlift to Houston

On Tuesday, MHA President & CEO Lynn Nicholas, FACHE, took a phone call from an old colleague – Steve Jones, Jr., the CEO of Bay Area Regional Medical Center (BARMC) in Webster, Texas, just outside of Houston. Jones’ hospital was being hammered by Hurricane Harvey, and BARMC’s staff members, many of who had lost their houses to the floodwaters, fought exhaustion to stay on the job and deal with a spike in ED visits while being told to anticipate more admissions due to the closure of numerous area hospitals.

Jones told Nicholas he needed nurses and he needed them quickly.

By day’s end, after MHA had sent out a call to its membership assisted by the Organization of Nurse Leaders of MA, RI, NH & CT, Massachusetts nurses began to line up to travel to Houston. More than 80 nurses ultimately answered the call and on Tuesday, September 5, a plane chartered by BARMC will transport the first wave of Bay State nurses from Boston to Texas.

MHA coordinated the effort with the approval of the Texas Catastrophic Medical Operations Center (CMOC) whose approved disaster recovery plan calls for hospitals, if they are able, to arrange their own relief efforts. After vetting his plan with CMOC, CEO Jones then called Nicholas and her colleague at the New Jersey Hospital Association, which also assembled a contingent of volunteer nurses to fly to Houston; the New Jersey nurses deployed Thursday.

A combination of so-called “Good Samaritan” laws as well as emergency declarations from Washington and the Texas Governor’s office cut through the usual red tape governing cross-state licensing and credentialing, and malpractice concerns. BARMC is providing the transportation, lodging, and food for the volunteer nurses, most of whom will spend at least a week in Houston.

“Texas turned to MHA and Massachusetts for desperately needed assistance and we were able to quickly assemble a relief team of profoundly dedicated nurses,” said MHA’s Nicholas. “I couldn’t be prouder of the Massachusetts response, of our skilled and caring nurses, and of the Massachusetts hospitals that are ensuring that care at home is not affected adversely as our state’s nurses travel to help those in need.”

BARMC will arrange transportation home for the Massachusetts nurses either through another charter or through commercial flights. And a second group of Massachusetts nurses is standing ready if more help is needed.

“We’re not entirely sure of the transportation departure details – nor are the nurses who volunteered,”  Nicholas said. “We have a call with the folks in Texas Saturday to flesh that out, but I could not be prouder of the quick planning our team at MHA has done and the incredible response from the nursing community.”

How to Help Colleagues in Texas

On Wednesday when MHA was on a coordinating call with Bay Area Regional Medical Center leadership and a representative from the Texas Catastrophic Medical Operations Center it was revealed that a number of their staff members, including some on the call, had nowhere to go after leaving work. They had lost their homes to the flood.

Many Texas hospital employees are working around the clock while their lives and the lives of their families have been affected by the destruction from Hurricane Harvey. If you would like to help Texas hospital workers, the Texas Hospital Association has provided a way to help: click here to learn more and to donate.

All funds will directly assist hospital employees in Federal Emergency Management Agency-designated disaster areas; administrative services are being provided in kind so that 100% of donated funds will be used to assist hospital employees.

FY2018 Acute Care Hospital RFA is Out

The state has released the 2018 Request for Applications (RFA) – the main contract between the MassHealth program and acute care hospitals serving Medicaid patients.

This year’s RFA is somewhat unusual in that it creates two distinct rate periods – one that runs from October 1, 2017 to February 28, 2018, and then another that follows to Fiscal year’s end that covers the effective dates of the new, sweeping MassHealth Accountable Care Organization (ACO) and Managed Care Organization (MCO)  programs.  The rate changes that take effect in the second half of the year are intended to coincide with other financial payment policies associated with these new programs.

“This proposed policy effectively moves the state into setting the reimbursement rates paid by MCOs to hospitals, reimbursement that has been customarily negotiated between hospitals and MCOs,” said MHA’s Executive Vice President Tim Gens.  “This action puts hospitals at a significant disadvantage with these insurers, eliminating the possibility of a fair negotiation. The ability of hospitals and other providers to negotiate independently with MCOs is critical to ensure the added value a hospital may provide to support care management of MCO enrollees and to be a key network provider for the MCO in a particular service area.”

A Very Busy August ...

The so-called August policy-making lull has been anything but relaxing for MHA as the association was active over the past two weeks at both the state and federal levels, commenting on  the MassHealth waiver amendment, Health Safety Net funding, Medicaid DSH funding, and, most recently, waiving certain aspects of the Affordable Care Act.

In an August 21 letter on the MassHealth waiver to the Executive Office of Health and Human Services (EOHHS), MHA weighed in on Governor Baker’s proposed changes to MassHealth coverage, including the proposal that disallows MassHealth coverage for non-disabled adults who have access to affordable employer health insurance. MHA took a deep dive into the waiver, analyzing in depth nine of its specific proposal. MHA stated that the administration’s proposed MassHealth reforms can serve as the basis for addressing the sustainability of the MassHealth program.  MHA also noted that improvements must be made to it to ensure than any changes to health coverage are affordable and take into consideration low-income patients who may fall through the cracks.

In an August 11 letter to new House Ways & Means Chair Jeffrey Sánchez and Senate Ways & Means Chair Karen Spilka, MHA made a strong pitch to include much needed  legislative language for a $15 million transfer to the Health Safety Net (HSN) as part of the supplemental budget. With one month remaining in Health Safety Net 2017 fiscal year, a state funding transfer has still not occurred.

On August 28, MHA submitted formal comments to CMS Administrator Seema Verma, asking CMS to delay its proposed rule to implement Medicaid State Disproportionate Hospital allotment reductions beginning in FY2018.  According to CMS estimates provided in the proposed rule, Massachusetts will experience a 31.45% reduction in FY2018 alone – the largest reduction in the country. The outlook for further reductions is overwhelming given the cuts increase each year and will effectively quadruple by 2024.

On August 24, MHA wrote to the Health Connector on the issue of the state’s proposed “Section 1332” waiver to the Affordable Care Act. Through that waiver, the state hopes to establish a Premium Stabilization Fund in lieu of federal Cost-Sharing Reductions (CSRs) for low-income enrollees who purchase health insurance in the Connector.  MHA supports the state’s efforts but added: “If a Premium Stabilization Fund is created on the commonwealth’s books, it should be crafted in a manner that includes protective language to ensure these funds cannot be used for other purposes.”

... and an Important September Hearing

On Sept. 6 and 7, the U.S. Senate Health, Education, Labor and Pensions Committee will host hearings on stabilizing premiums and helping individuals in the individual insurance market for 2018. The hearings have been described by its chairman Lamar Alexander (R-Tenn.) and Ranking Member Patty Murray (D-Wash.) as a bipartisan effort to correct the Affordable Care Act without attempting to entirely destroy it. On Sept. 6, state insurance commissioners will testify. On Sept. 7, Governor Baker is expected to testify.

Learn About Lean at October 17 Forum

Join the Massachusetts Lean Health Network on Tuesday, October 17 for a special evening program: “Healthcare's Best Improvers: Learning from Virginia Mason Institute and Catalysis (formerly ThedaCare Center for Healthcare Value).” A dedicated lean journey in healthcare is an arduous climb but having a mentor along can help you navigate culture change, resistance, and questions from executives and staff about pace and expectations. Hundreds of U.S. healthcare systems are working with experts from two of the most experienced and written-about lean hospitals in the U.S. (Virginia Mason in Seattle, and the former ThedaCare in Appleton, Wisconsin). Both have published multiple, highly recommended books about their journeys, and have formed or spun off training or consulting units. On October 17, the Mass Lean Health Network will learn from several New England health systems who are working with Catalysis or VMI. Please e-mail mhln2009@gmail.com to save your spot.


Susan A. MacKenzie, Ph.D., has been appointed acting director of Edith Nourse Rogers Memorial Veterans Hospital. Prior to the appointment, MacKenzie served as the director of the Providence Veteran Affairs Medical Center, deputy medical center director of the VA Boston Healthcare System, and the deputy network director of the VA New England Healthcare System. She holds a Bachelor's degree in Health Science, a Master’s of Public Administration and a Doctorate in Health Policy, all from Northeastern University.

Alice E. Moore, the current undersecretary for health in the Massachusetts Executive Office of Health and Human Services, will leave her post to become deputy executive vice chancellor for Commonwealth Medicine, effective October 1.  Moore’s previous positions include chief of staff to then-Massachusetts Senate President Therese Murray and counsel to the Massachusetts Senate. She was deeply involved in healthcare reform legislation, including Chapter 224 of the Acts of 2012. Moore holds a JD from Suffolk Law School, and a B.A. from the University of New Hampshire.

16th Annual Women Leaders in Healthcare Conference

Thursday, September 28; 9 a.m. to 2:30 p.m.
Sheraton Framingham Hotel

Working in hospitals and healthcare in today is challenging – but also exciting. As a leader (or emerging leader) in your organization, how will you use your skills and talents to help drive change and get noticed? How will you step up and make your mark in your department, your division or your organization? At this year’s program, we will hear from seasoned experts and leaders who have blazed trails in healthcare and other sector. Our speakers will share lessons learned and advice about how to forge effective leadership paths. We’ll also take a look at important career communications strategies and share tips on keeping yourself healthier while on the job. Join us at this always-informative program where the networking can’t be beat! In addition to the terrific program, we’ll have a photographer on site to take head shots that may be useful for your career and networking.  All attendees will have a chance to win a weekend at the Chatham Bars Inn.  Review the full agenda, speakers, and registration info here.

John LoDico, Editor