Tim Gens, Mass. is Healthiest State, and more...

Tim Gens – the Heart and Soul of MHA – to Leave MHA

Timothy “Tim” Gens, who has provided both the intellectual and compassionate foundation for MHA’s strategy and policy efforts over the past 23 years, announced he will leave the association, effective December 31.

Gens, MHA’s Executive Vice President and General Counsel, had announced his intentions to the MHA Board and to staff in November.
Every major Massachusetts healthcare development over the past two decades bore the imprint of Gens’ leadership and influence in one manner or another, from the state’s efforts to expand coverage and reshape payment infrastructures, to advances in transparent public reporting of healthcare outcomes, and the development of nationally recognized patient safety improvements.

While Gens would be the first to credit the men and women he worked with over the years for any success he enjoyed, those staffers in turn have praised Tim for his ability to craft solutions to healthcare issues, and then to develop the association’s strategy necessary to bring those solutions to realization.

Gens' vision led to the creation of what is now known as PatientCareLink – the mechanism through which Massachusetts hospitals became the first in the nation to voluntarily post staffing data for all units in every hospital. Before the national Institutes of Medicine published its groundbreaking report on medical errors, Gens was instrumental in helping the Massachusetts hospital community move towards the acknowledgement that serious injury to patients merited a unified response; those efforts led to the creation of the Massachusetts Coalition for the Prevention of Medical Errors.

The commonwealth’s Uncompensated Care Pool – progressive in its creation but consistently underfunded – had over the years become the source of division between the state and the hospital community.

As MHA’s founding representative on the Affordable Care Today (ACT!!) Coalition, Gens was a leading proponent of resolving the pool issue by improving affordable and comprehensive coverage to the uninsured. He was instrumental in getting MHA and the hospital community behind the coverage expansions and “individual mandate” concepts that led to the commonwealth’s historic Chapter 58 healthcare reform law in 2006, and which later became components of the national Affordable Care Act.

He also understands that to provide excellent care to the patient – the center of all MHA and hospital community efforts – providers need fair reimbursement from public and private payers. The state and national debates over Medicaid and Medicare funding, the annual state budget discussions, and the new payment mechanisms that arose through special commissions in the commonwealth have all been influenced by Gens-driven strategy from MHA. While governors, legislators, and members of Congress recognize him as an advocate for his specific hospital constituency, he is also respected as a trustworthy and fair voice, insisting that the data MHA presents in making its arguments be based in solid scholarship. Of special note, Gens’ work related to the Medicare area wage index issue has greatly benefited MHA’s member hospitals.

His friends and associates appreciate him as a master strategist, able to see how an action in one regulatory agency or legislative office could rebound and affect another issue months down the line in another part of state government. An extraordinarily personable man, possessing a wonderful sense of humor, Gens has befriended many people within the healthcare community, forming relationships with labor leaders and employers, with hospital executives and insurers, patient advocates, nurse leaders, and more.

His current and past colleagues met recently at MHA to celebrate his time at the association. They reflected on not only his professional accomplishments but on how he has mentored many younger staff members on fundamental issues of character, compassion, and respect. Co-workers shared stories of Gens’ kindness in taking an interest in matters, both inside and outside of the office, that affected them. They recalled how almost every department would say, “Let’s run this by Tim” before taking action on a wide variety of issues.

Three years ago, in a small MHA celebration of staffers who had reached their fifth, tenth, fifteenth, or in Tim’s case, twentieth anniversary at MHA, he said, “MHA gets to advocate for a variety of major healthcare policy ideas that can help a lot of people, and to influence those ideas on both a state and national level. I am grateful for the opportunity to work on these challenges. But more important than the policies are the people I’ve worked with – and I’m especially grateful for my family. For me, the words that best describe what makes MHA special are: talent, collaboration, caring, and dedication.”

MHA thanks Tim for his talent, collaboration, caring, and dedication that has set a high standard for his peers – but also for the joyous nature he has brought to our work and the deep friendships he's formed with his colleagues. We know that the many people who are reading this small tribute and whose paths have crossed with Tim’s over the years join us in wishing him peace and happiness.

We’re Number 1! Mass. Health Status Tops Annual List

Massachusetts is the healthiest state in the union, according to a new survey from United Health foundation.

The annual ranking assesses 35 measures ranging from ones related to “Behaviors” (obesity, smoking, excessive drinking, among others), to “Community & Environment” (air pollution, infectious disease, violent crime, etc.); to “Policy” (immunizations, public health funding, rate of uninsured, etc.); to “Clinical Care” (number of dentists, mental health providers, and primary care physicians, etc.); and “Outcomes” (cancer and cardiovascular deaths, infant mortality, etc.).

Massachusetts’ strengths are in its low percentage of uninsured population, its low obesity rate, and a higher number of mental health providers. The commonwealth, however, has a high rate of drug death (per 100,000 population) and large disparity in health status by educational attainment; that is, there is a large gap in the commonwealth between those with a high school education and those without who report that their health is good to excellent.

The state ranking Number 50 is Mississippi.

The Coalition to Protect Patient Safety, of which MHA is a founding member, said the state’s top ranking is impressive, but added, "Our system, however, is fragile and adverse impacts from the proposed nurse staffing ballot question in 2018, can easily put patient health and safety at risk. The rigid, costly nurse staffing measure will drive up consumer healthcare costs without increasing the quality of care, and will lead to the closure of financially vulnerable community hospitals. We must not let politics stop our state's progress or jeopardize our nationally valued ability to provide affordable, quality healthcare."

HPC to Review Multi-Hospital Merger

The deal involving Lahey Health, the Beth Israel Deaconess system, three independent hospitals, plus a number of physician practices will get a full cost and market impact review (CMIR) from the Health Policy Commission, following a full commission vote on the issue last Tuesday.

Under a CMIR process, HPC staff perform a detailed investigation to determine how a proposed merger will affect healthcare costs, access, healthcare quality, and how the market functions. The HPC doesn’t have the authority to stop a proposed merger but if it finds a transaction is detrimental to the state’s overall healthcare system it can refer its report to the Attorney General’s office, which does have the power to approve or reject a merger.

The deal at issue would create a new system consisting of the current Beth Israel Deaconess Medical Center, Beth Israel Deaconess Hospital – Needham, Beth Israel Deaconess Hospital – Plymouth, and Beth Israel Deaconess Hospital – Milton, along with the Lahey-owned Lahey Hospital & Medical Center, Beverly Hospital, and Winchester Hospital. Also included are the independent Anna Jaques Hospital, New England Baptist Hospital, and Mount Auburn Hospital.

Under the proposed deal, the new system would control the following contracting entities: Beth Israel Deaconess Care Organization (BIDCO), the Lahey Clinical Performance Network and Lahey Clinical Performance ACO. Mount Auburn Cambridge Independent Practice Association, which currently contracts independently, would be brought under the umbrella of the new system.

HPC’s review could run into July 2018.

The hospitals and physician practices involved in the deal argue that they will be able to attract care away from higher-priced systems and drive down total healthcare spending in the state. They also argue that they’ll be able to create new insurance products, invest in alternative payment systems, and expand access to needed services, including behavioral health and primary care. In a media release the Lahey-BIDMC group said they welcome the HPC review as a way to show their claims about the new system have merit.

HPC Votes to Shake Up its Subcommittees

The Health Policy Commission says it is restructuring its standing subcommittees to better align them with “priority policy outcomes.” Following last Tuesday’s vote, gone are the standing committees on Quality Improvement and Patient Protection, Cost Trends and Market Performance, Care Delivery and Payment System Transformation, and Community Hospital Investment and Consumer Involvement. Replacing them are standing committees on Market Oversight and Transparency, and Care Delivery Transformation. The previous Administration & Finance subcommittee will remain under the reorganization.

Flu is “Widespread” in Massachusetts

DPH reported last week that influenza-like illness (defined as a fever greater than 100 degrees F with cough and/or sore throat) was “widespread” in Massachusetts.  The rate of flu this year is greater than it was in the previous two years. In those years the flu peaked in February and March.  All parts of the state, except the central region are reporting increased influenza-like illness from previous weeks.   Detailed weekly flu surveillance reports are posted on the Mass Public Health Blog.  The national CDC reports that, surprisingly, roughly 3 out of 5 Americans have not yet received a flu vaccine for the 2017-18 flu season.


The president of Baystate Franklin Medical Center Cindy Russo has announced her resignation, effective January 12.  Ron Bryant, president of Baystate Noble, will be the interim president of Baystate Franklin until a new CEO is named. Russo has been president of Baystate Franklin since June 2016.

2018 Joint Commission Update

Thursday, January 18, 2018; 9 a.m. to 2:30 p.m.
Conference Center at Waltham Woods, Waltham, Mass.

Hospitals need to stay abreast of the evolving compliance issues and shifting priorities regarding Joint Commission accreditation. At this year’s conference, we’re bringing back popular speaker Mark Crafton, executive director for state and external affairs at The Joint Commission. Mark is the expert on Joint Commission standards and he’ll provide an update on the challenging standards from 2017 and highlight some of the new standards for 2018. We will also feature a "hot-topics" session and conclude the program with a panel of your colleagues from recently surveyed hospitals to share tips and updates about current priorities. We hope you’ll join us. Click here to register.

John LoDico, Editor