The House Reform Bill, and more ...

Mass. House Releases Major Healthcare Overhaul

The Massachusetts House of Representatives could begin consideration as early as tomorrow on a massive healthcare reform bill. The legislation, entitled “An Act Establishing the Honorable Peter V. Kocot Act to Enhance Access to High Quality, Affordable and Transparent Health Care in the Commonwealth,” was released from the Joint Committee on Health Care Financing last Tuesday. Amendments were due by close of business Friday in anticipation of this week’s debate.

The proposal, while narrower in scope than the legislation approved by the State Senate last November, addresses many of the same policy issues.  The House bill also contains provisions to expand telemedicine services, increase state oversight of the pharmaceutical industry, address patient “surprise billing,” and stabilize community hospitals.  However, the two chambers chose very different approaches in how best to address these challenges. 

Last week, MHA released a statement on the legislation, saying that “the broad intent of the House healthcare bill – increasing access, improving quality, reducing costs and enhancing transparency – reflects goals shared by hospitals and the broader healthcare community.” MHA continues to engage in conversations with the House and will be closely following the debate process.

Rep. Clark’s Bill Would Help Fight Opioids in Underserved Areas

The U.S. House of Representatives last Tuesday unanimously passed a bill co-sponsored by Massachusetts Representative Katherine Clark (D) and Hal Rogers (R-Ken.) that offers student loan repayment of up to $250,000 for graduates who agree to work as a substance use disorder treatment professionals in areas most in need of their services.

“Today, Congress took a major step forward in our fight to combat the opioid crisis,” said Clark. “Every new treatment professional we invest in could mean survival for someone’s child, parent, sibling, or friend who may not have had access to treatment otherwise. Communities across the nation are calling on us for solutions and this legislation provides the support needed to facilitate their recovery and health.”

To qualify for the program, participants must agree to be employed in a full-time substance use disorder treatment position in a high-need area for up to six years. That job must involve serving in a direct patient care role and can include serving as a physician, registered nurse, nurse practitioner, social worker, recovery coach, or any other role listed in the bill (H.R. 5102).  The bill now moves to the Senate along with other opioid-related legislation the House focused on last week.

AMA Denounces “Carnage of Gun Violence”

The American Medical Association’s (AMA’s) House of Delegates – the group’s policy making arm – met last week and adopted a series of positions, including those addressing gun violence and pharmaceutical shortages.

The gun policy recommendations include having the AMA support laws allowing family members, intimate partners, household members and law enforcement personnel to petition a court for the removal of a firearm when there is a high or imminent risk for violence; prohibiting persons who are under domestic violence restraining orders, convicted of misdemeanor domestic violence crimes or stalking from possessing or purchasing firearms; and requiring domestic violence restraining orders and gun violence restraining orders to be entered into the National Instant Criminal Background Check System. AMA will also advocate for schools to be gun-free zones and oppose requirements or incentives for teachers to carry weapons.

“In emergency rooms across the country, the carnage of gun violence has become a too routine experience,” said AMA Immediate Past President David O. Barbe, M.D.  Read all of the AMA’s gun proposals here.

As for pharmaceuticals, the AMA said the recent shortages that resulted from Hurricane Maria’s effect on pharmaceutical manufacturing in Puerto Rico demonstrate that the federal government should consider drug shortages “a national security initiative” and that vital pharmaceutical production sites should be considered “critical infrastructure.”

Strike Averted; Staffing, Wages Determined by Negotiations

Late Thursday night, Berkshire Medical Center and the Massachusetts Nurses Association reached an agreement on a contract, averting a strike planned for today. The proposal must be ratified by the hospital’s MNA nurses.

Both sides said the agreement was reasonable, and Berkshire issued a statement that read, “With the distraction and divisiveness of strike threats gone, we look forward to returning our focus solely to delivering the high-quality patient care that our community rightly expects of us.”

If the contentious negotiations proved anything it is that staffing concerns are part of active contract negotiations and should be settled on a case-by-case basis as part of the bargaining process. Imposing one-size-fits-all staffing on all hospitals – regardless of their size, patient makeup, education of nurses, or other factors – not only does not make sense for patient care, but it subverts the collective bargaining process.

CMS Once Again Sees the Light, Delays Star Ratings

CMS will not update Hospital Compare’s quality star ratings in July as scheduled. Instead, the agency will further study the responses it received from parties that objected to the proposed change in methodology used to apply the ratings to hospitals.  Star ratings in July 2017 were also delayed due to concerns from stakeholders. The most current star ratings on the Hospital Compare site are from December 2017.

While providers generally endorse the usefulness and accuracy of the dozens of measures contained on Hospital Compare, they have consistently objected to the way CMS groups and weighs the diverse measures to come up with a simple – and oftentimes misleading – one-to-five star rating.

You can rate a restaurant or refrigerator with stars, the healthcare community has argued, but not complex hospitals.

Banks Receives ONL’s Conceison Award

Congratulations to Maureen Banks, the COO of the Spaulding Rehabilitation Network and a member of the MHA Board of Trustees, who last Thursday at the Organization of Nurse Leaders’ annual meeting was presented the Mary B. Conceison Award for Excellence in Nursing Leadership. ONL’s highest award recognizes outstanding contributions made by a nursing service administrator. Conceison was director of professional relations at the Massachusetts Hospital Association for 12 years before her death in 1981.

Caring for Elderly Patients: Best Practices and Innovations

In 1900 the average lifespan was 47 years. Americans can now expect to live to well over 80. By 2050, the number of people 65 years or older is expected to significantly outnumber children younger than five years of age. At the same time, birth rates are decreasing across the globe, leading to an increasingly grayer world with a higher proportion of older citizens living longer lives. This will affect many areas of society, from politics to business. But there is one area that will be affected more than any other – healthcare. Hospitals and other providers of care will need to adopt innovative approaches to this societal shift. Caregivers will need to be retrained in new technologies, including the growing prevalence of post-care monitoring. This conference -- on Friday, June 22, from 8:30 a.m. to 2:30 p.m. at MHA Conference Center in Burlington -- will attempt to explore the changes we can expect due to our increasing longevity and look at resources and new care delivery models for providers. We’ll also provide a legal update on recent legislation affecting elder care in Massachusetts hospitals.  Click here for registration information.

John LoDico, Editor