New $750K Grants, 340B Lawsuit, and more...

New $750K Grants Available Through HPC

The Health Policy Commission (HPC) last Wednesday announced a new grant program for eligible providers to help them reduce avoidable acute care use “by investing in innovative care delivery models that are community-based, collaborative, and sustainable.”

Up to $10 million is available, which comes from remaining funds in the Distressed Hospital Fund and the Payment Reform Fund,  which was funded from gaming revenues. The HPC said CHART-eligible hospitals and HPC-certified ACOs and ACO participants will be given preference for the awards, which can range up to $750,000 each. Applicants are responsible for a 25% in-kind financial contribution.

There are two funding tracks. One is for innovative models that address health-related social needs of complex patients to prevent a future acute care hospital visit. The other is for innovative models that address the behavioral health care needs of complex patients. HPC specified that it will use up to $3 million of the $10 million to address opioid use disorder treatment in the ED by initiating medication-assisted treatment and connecting patients to community-based behavioral health services.

HPC Executive Director David Seltz said at the HPC meeting, “We think that with this $10 million investment we can continue to be in support of the leading edge of some of these models that can do two great things: have great patient outcomes and also reduce costs and unnecessary utilization.”

The HPC said it will work with MassHealth to ensure the new HPC funding is coordinated with the goals of the MassHealth Delivery System Reform Incentive Program (DSRIP). To avoid duplication between the two somewhat similar programs, HPC stipulates that “certain patient populations receiving enhanced services through MassHealth ACOs and DSRIP funding may not be included as target populations for HPC funds.”

The full RFP is expected to be released this week.

HPC Refers Partners-Mass Eye and Ear Merger to AG

The Health Policy Commission (HPC) last week issued its final review of the proposed merger between Partners HealthCare and Massachusetts Eye and Ear, indicating that it “is likely to increase health care spending due to expected increases in hospital and physician prices.” The HPC also stated that due to Partners’ “dominant market share,” it is mandated to refer the proposed merger to the Attorney General’s office for further review.

DPH is also reviewing the merger through its Determination of Need lens; the HPC said it will forward its final report on the transaction to DPH to assist it in its DoN review.

The HPC said that the merger will raise healthcare spending in the state between $20.8 million to $61.2 million per year. Partners said there would be an increase but not as great as the HPC estimates. Mass. Eye and Ear said that its finances have been weakened in the judgment of rating agencies and that it needs the merger for stability and to continue to provide high-quality care.

Partners said in a statement, “This partnership will strengthen the clinical and scientific relationships between our organizations and will make Mass. Eye and Ear services and research accessible to a broader population of patients.”

Federal Court Dismisses Lawsuit Challenging 340B Cuts

On December 29, the U.S. District Court for the District of Columbia dismissed a lawsuit filed against the Department of Health and Human Services regarding a Medicare reimbursement policy that would reduce hospital payments for outpatient drugs purchased through the 340B Drug Pricing Program.

Because the policy was allowed to take effect on January 1, it is expected to reduce Medicare hospital reimbursements by $1.6 billion. 
The American Hospital Association, Association of Medical Colleges, America’s Essential Hospitals, and several individual hospitals filed the lawsuit. The judge did not rule against the merits of the case, but specifically stated that the plaintiffs failed to exhaust other means of challenging the policy prior to the January 1, 2018, implementation date.  As a result, the plaintiffs have the opportunity to pursue the case now that the cuts have been implemented.

On a separate track, supporters of legislation introduced in December to stop the implementation of the Medicare 340B cuts that CMS included in the outpatient PPS rule, are now pushing for a moratorium on the new outpatient 340B rule. With the current federal spending bill expiring on January 19, the 340B champions are pushing for the moratorium to be included in the next spending bill to be completed by January 20. Chances of success remain unclear.

The new outpatient rule means CMS will reimburse hospitals for drugs purchased through the 340B program at the average sales price minus 22.5%. The 340B legislation, HR 4392, was introduced by Reps. David McKinley (R-W.Vir.) and Mike Thompson (D-Calif.), and a growing number of Massachusetts House members have signed on to the bill. The current Massachusetts co-sponsors are Reps. Joe Kennedy, Mike Capuano, Jim McGovern, Niki Tsongas, Stephen Lynch, Seth Moulton, and Katherine Clark.

Need an Expert? MHA Creates New Speakers Bureau

MHA – known for its innovative and timely education offerings – is now offering H Speakers to assist hospitals and other organizations find expert speakers to communicate to their employees, community leaders, and board members the most important and relevant healthcare news.

H Speakers leverages MHA’s extensive expertise to help hospitals and healthcare organizations develop high-quality, relevant programs for their audiences.

Drawing from a select list of top speakers with deep expertise on critical healthcare topics, H Speakers can help organizations find knowledgeable presenters for any board retreat, leadership program, conference, or workshop. Expert H Speakers can teach or facilitate sessions at a specified destination – whether on-site at a hospital or office, or away at a conference or retreat. (Hospitals and other organizations seeking space for an event can contact MHA, which offers a state-of-the-art conference center at its headquarters in Burlington, Mass.)

H Speakers can bring expertise directly to organizations, providing accurate information and training at a fraction of the cost of sending people out to programs.

For more information on H Speakers, please visit here or call (857) 770-1281.

A Move to Ensure RNs Have BS Degrees

At the end of last year, New York passed a law requiring future RN graduates of associate degree and diploma nursing programs to get a baccalaureate degree in nursing within 10 years after initial licensure in the state.

The American Nurses Association—NY supported the "BS in 10" measure, in which currently licensed RNs, nursing students enrolled in diploma or associate degree programs, or applicants on a waitlist for a nursing program, are grandfathered and their licenses protected from the additional educational mandate.

A similar MHA-priority bill (HB1186) is now pending in the Massachusetts legislature. “An Act to Promote Patient Care Transparency and Nurse Advancement” would, among other workforce improvements and enhanced transparency measures, establish a commission to design academic pathways and necessary supports to advance the goal of having 95% of all registered nurses in Massachusetts achieve the baccalaureate degrees by 2030. The legislation is aligned with the efforts of the Massachusetts Action Coalition to advance the nursing profession.

The bill seeks to create new competency-based curricula, seamless educational progression, more funding for accelerated programs, educational capacity building, and student diversity.

Research shows that one of the strongest correlation between nurses and patient care outcomes is the education and experience level of the nurse.

“Empowering nurses and helping them achieve their full potential through the measures outlined in HB1186 makes more sense – for RNs and patients – than advocating for outdated and misguided proposals such as mandatory nurse staffing ratios, at all times, in all hospitals via ballot question,” said MHA VP of Clinical Affairs Pat Noga, R.N.

BORN Adjusts Timeline for Mandated Training

As part of the 2014 “Act Relative to Domestic Violence,” DPH was tasked with creating domestic and sexual violence training for professionals receiving licenses from various boards, such as the Board of Registration in Nursing (BORN).

Recently BORN sent out a notice informing nurses that an e-learning tool that will be housed on its DPH’s Domestic and Sexual Violence Integration Initiatives web page is not yet up and running. Therefore BORN will not hold a nurse responsible for the required training until it is available. After the training information is posted on BORN’s website, nurses who have not yet renewed in 2018 will have an additional six months to complete the training. Nurses who have renewed prior to the posting must complete the training prior to their next renewal. A nurse participating in a currently approved in-person training program will be considered to have met the requirement and does not need to take the online course by DPH.

MHA will assist BORN distribute notice to hospitals once the e-learning tool is functional.


Denise Schepici is the new president & CEO of Martha’s Vineyard Hospital, effective January 16. She takes over from Interim President Timothy Walsh, who was previously the full-time president, and who stepped back into the top role when his successor left in 2017. Schepici is well known in Massachusetts healthcare having served in the field for more than 30 years in many roles. She most recently was chief administrative officer at MetroWest Medical Center in Framingham, and before that was Tufts Medical Center’s V.P. of clinical services.

MHA's 51st Annual Mid-Winter Leadership Forum

Friday, January 26, 2018; 9 a.m. to 2:45 p.m.
Sheraton Framingham Hotel

Don't miss MHA's most informative leadership meeting of the year. As you can see in some of the stories below, the atmosphere on Beacon Hill and in Washington, D.C. continues to be volatile, creating daily challenges for hospital and healthcare leaders. At this year’s Mid-Winter Leadership Forum, we will take a deep dive into the most pressing legal and regulatory issues for hospital leaders, including Medicaid, healthcare costs, opioids, and current legislative initiatives. We’ll also discuss how telemedicine will change the Massachusetts care delivery landscape and reimbursement system — and how it’s already made an impact in other states. Speaker of the Massachusetts House Robert DeLeo is the Forum’s special guest speaker. We’ll conclude with a session with local commentators Jim Braude and Margery Eagan — always cogent and incisive — speaking about how to keep today’s headlines in perspective. It’s a don’t-miss program. Click here now to register.

John LoDico, Editor