massachusetts hospital association


Hospitals Worry Meningitis Fallout May Worsen Drug Shortages


Hospitals across the state are worried that the temporary closure of a pharmaceutical manufacturer in Westborough may increase the chronic problem of drug shortages.

Ameridose is a key supplier of IV antibiotics and prefilled syringes. There are no reported problems with Ameridose products, but the company stopped operations while an investigation of contaminated steroids at a jointly owned pharmacy, New England Compounding Center, is under way.

The Massachusetts Hospital Association says the effects of the Ameridose shutdown vary widely, depending on a hospital’s reliance on the company. At Massachusetts General Hospital, Dr. Elizabeth Mort says the hospital is looking for new suppliers:

“If, however, Ameridose is closed for a prolonged period of time, it will be all the more challenging to keep the drug supply uninterrupted to our patients.”

The state has agreed to help hospitals manage and replenish shortages that arise while Ameridose is closed.

Mass. Hospitals Rate Local Health Plans, Knock Blue Cross Contract Talks

report card

(Wikimedia Commons)

This just in from the Massachusetts Hospital Association:

Massachusetts Hospitals Rate Performance of Health Plans

A performance satisfaction survey of the commonwealth’s 13 health insurers that the Massachusetts Hospital Association conducted has identified a variety of strengths and weaknesses among the health plans, with administrative burdens remaining frustratingly high across the board, but local- based insurers faring better overall than their national counterparts.

Some 30 hospital systems representing 35 Massachusetts hospitals shared their thoughts on the administrative performance of health plans in areas such as claims adjudication, communication capabilities, credentialing and re-credentialing processes, and conducting two-way, good-faith negotiations. This is the third insurer satisfaction survey that MHA has participated in or administered…

Some of the highlights of the survey include:

Overall satisfaction with the payers varied substantially by individual insurer. Harvard Pilgrim Healthcare (HPHC) received the highest marks. Problems that contributed to provider dissatisfaction with the insurers included plan rigidity even when resolving difficulties the plan itself created (Blue Cross Blue Shield of Massachusetts); glitches with the insurer’s billing system and long appeal lag time (Fallon Community Health Plan); and problems with insurers authorizing a visit, then stating at the time of payment that a member was not eligible (United Healthcare and Aetna).

HPHC, Tufts Health Plan (Tufts) and Fallon scored very well on their contract negotiation conduct with providers – more than 75% of the hospital respondents said those three insurers conducted two-way, good-faith negotiations with providers during contracting. But 73% of the survey respondents were dissatisfied with Blue Cross Blue Shield of Massachusetts’ contract negotiation, and 59% were dissatisfied with Neighborhood Health Plan on this measure. Continue reading

Biggest Health Challenges: Flu, Polio, Wars — And Now Costs

Massachusetts General Hospital president Peter L. Slavin

Massachusetts General Hospital president Peter L. Slavin (MGH)

The Massachusetts Hospital Association just sent over word about its June 7 annual meeting, including the news that Massachusetts General Hospital president Peter L. Slavin is the association’s new chair of the board of trustees.

It included this:

In his inaugural speech that called for the hospital community to unite during the healthcare reform efforts now under way in the state, Slavin said “For more than 200 years, the hospital community in this state has tackled our society’s most significant health care challenges — influenza epidemics, polio epidemics, and world wars to name a few. I would argue that perhaps the most significant threat to the future health of the people of Massachusetts is the rising cost of healthcare itself. We must tackle this challenge head on just like the others. To do so is our greatest challenge, our solemn responsibility, and a remarkable opportunity for us to lead.”

My first reaction: Flu, polio, war — and health costs? Doesn’t that list end a little anti-climactically? (I’m reminded of the chorus “For God, For Country and For Yale,” cited as “the outstanding single anti-climax in the English language.”) On the other hand, if health costs are crowding schools and safety and more out of public budgets, then perhaps — ? If costs are keeping people from care, as today’s poll suggests? Readers, thoughts?

For Massachusetts medical insiders, here are the new MHA officers: Continue reading

MA Hospital Association Opposes AG’s Call For Health Care Price Caps

Attorney General Martha Coakley

Mea culpa. In our round-up yesterday of reactions to attorney general Martha Coakley’s latest report on health care costs, I missed the substantive comments from the Massachusetts Hospital Association. Their full statement is here, and I’d sum it up thusly:

-It will take a little time to delve into the report’s findings and methods.
-“Global payments and accountable care organizations are in the early stage of development and it is far too early to judge their potential impact.”

And the strongest language:

We strongly disagree with the AG’s recommendation that government temporarily regulate prices for services in the midst of evidence of dramatic changes in the healthcare delivery and payment system. The state system is evolving rapidly and many providers are contracting under alternative payment models including capitation, bundled payments and performance-focused incentive payments–these innovations should be given time to demonstrate their effect, not stifled by prescribing government-controlled price regulation. In addition, regulating prices is very complex, administratively burdensome and costly—it has been tried in Massachusetts before and failed. A lot of change is now underway in the healthcare system prompted, but not controlled, in part by government action. Rate regulation can result in unintended consequences such as interfering with the effective development of limited and tiered networks, which the Attorney General and many public policy leaders support.

First Hearing On MA Health Reform, 2011: Where Does Everybody Stand?

Okay. I’ve posted Attorney General Martha Coakley here. I’ve posted Gov. Deval Patrick here. Now for everybody else. Today’s State House hearing was the season opener, time for the players in Massachusetts health reform — from huge hospital systems to individual consumers — to stake out their opening positions. How do they see Gov. Patrick’s proposal for the next, cost-cutting phase of health care reform? What are their concerns?

Here’s my overarching impression: General support for the idea of shifting the system toward payment for “global” budgets for “whole-patient” care, away from fragmented payments for each service. And broad concern that if done wrong, it could hurt.

Full testimony is available from several major organizations. The Massachusetts Medical Society is here. The Pioneer Institute is here. Health Care For All is here. I’ll post more as I get them, and you’re deeply welcome to share links or thoughts in the Comments section below.

Meanwhile, here are some noteworthy moments from the first three hours or so of today’s hearing:

Dr. JudyAnn Bigby, secretary of health and human services, and the governor’s point person on the bill:

What’s wrong with our current health care system is that it “doesn’t consistently pay for the right thing.” That is, “The problem with the way we pay for care is that it’s based on insurance billing codes and not based on what patients need and what physicians are trained to do.”

Many payers and providers are already moving away from fee-for-service and forming more integrated care organizations, but it is a change that we must all approach with great care. It is because this transition requires thoughtful planning and should not take place in a haphazard manner that the governor’s bill is so necessary.

‘Our only beef, quite frankly, is that this is a very government-centric, Cabinet-centric approach’ — Lynn Nicholas, Massachusetts Hospital Association

Secretary of housing and economic development Gregory Bialecki:
“The health care cost crisis in Massachusetts is the primary roadblock to our continuing recovery.”

The governor’s bill “sends the message to businesses that their health care costs, which they see right now as being out of control, are going to become more consistent and more predictable and frankly more rational

Bialecki said he sees no evidence that the governor’s bill would hurt employment in the health care industry.

Not a return to the bad old days of HMOs

Rep. Steven Walsh, house chair of the committee, expressed concerns that the reform would be a throwback to the bad old days of HMOs, and people might find themselves unable to get care at top specialty hospitals such as Children’s Hospital and Dana Farber Cancer Institute. JudyAnn Bigby’s response: Continue reading

Will The Hospital CEO Against Payment Reform Please Stand Up?

One hospital chief is opposed to payment reform. Who is it?

Speaking in an auditorium full of people eager to change the way her members do business, Lynn Nicholas, president of the Massachusetts Hospital Association, said she wants to make one thing perfectly clear: every hospital in the state is on board with payment reform — except for one lone CEO. That’s right, apparently only one solitary chief executive is against it.

As for the rest of the hospital chiefs, whose renowned institutions, specialists and big name doctors stand to lose clout, money and patients, Nicholas said, they all really do support changing the mode of paying for and delivering care. “We are just as impatient as the governor on this,” Nicholas said.

Needless to say, I am now dying to find out which lone executive is standing against the tide of history here?

Nicholas wouldn’t say.

“I’d love to rat him out, but I can’t,” she said. “But really, if someone’s doing well in a fee-for-service environment, why would they want to change?”

So, dear readers, a health care parlor game: If anyone out there knows who this stalwart hospital executive is, please come forward. If you don’t know, how about venturing a guess? Or better yet, if the executive in question would like to out himself or herself, and tell all, here’s a chance to have your say.

Mass. Hospital Association Steps Into Nurse Staffing Dispute

Lynn Nicholas, President & CEO of the Massachusetts Hospital Association, posted a comment today in response to our story about the controversy over nursing staff levels at Tufts Medical Center.

(For background: earlier this week, CommonHealth published an analysis of nurse staffing ratios based on data from Patient Care Link, a public website maintained by the hospital association. That analysis found that Tufts Medical Center nurses appear to be spending less time with patients compared to nurses from other Boston teaching hospitals. The Tufts nurses, in the middle of tense contract negotiations with the hospital administration, say their diminished staffing levels are hurting patient care; the hospital says care remains top quality.)

We thought that the comments from Nicholas, of the MHA, were worth a separate post, so here it is:

It’s All About Outcomes

We knew when we created PatientCareLink in 2005 that we’d provide the public with the most transparent view of hospital nurse staffing in Massachusetts. However, we were concerned that nurse staffing hours might be misinterpreted as the sole measure of patient care. They shouldn’t be. Registered nurses are essential and valued members of the care-giving team – but it still takes a team to care for patients. And the team’s performance should ultimately be judged by the care patients receive.

Tufts has it right in its response. The key word in any discussion of patient care is “outcomes,” the results of the comprehensive care provided to patients.

It is correct to place extraordinary value on the efforts of RNs – but it would be wrong to undervalue every other person contributing to a patient’s care. Nursing assistants, technicians, patient sitters (who monitor patients at risk of falls and help them enter and exit beds, among other duties), pharmacists, respiratory therapists, physical therapists, and others who are constantly attuned to the needs of patients. Comprehensive patient care should be about how the dedicated, professional team provides care to each and every patient.

I’d encourage anyone visiting PatientCareLink to examine hospital staffing – that is why we publish that information. But make sure to look beyond the nurse staffing numbers to understand the bigger picture of how patients are cared for in hospitals. Find out how every day – in fact, every fraction of an hour of every day – hospital workers operate as one unified entity to collectively drive healthcare quality and patient safety forward.

This publication, which is also available on PatientCareLink, highlights the ongoing improvement in quality and patient safety at Massachusetts hospitals.

Clearly, the issue isn’t going away. Tomorrow, March 16, Tufts nurses and their union, the Massachusetts Nurses Association will hold “an informational picket and rally from 4 – 6 p.m. to call for desperately needed improvements in patient care conditions at this major Boston-based teaching hospital.”

No Smokers, Says Mass. Hospital Association

Smoking doctor (in China, where it's common even during exams)

Check out this provocative story from WBUR’s Martha Bebinger.

BOSTON — No Smokers Need Apply.

That’s the message you’ll hear from the Massachusetts Hospital Association (MHA) starting Jan. 1. A ban on hiring smokers as police officers or firefighters has been in place in Massachusetts since 1997, but the hospital association could be the first to take restrictions in the private sector to a new level. It hopes to become the model as employers get more involved in their employee’s health care.

Readers, what do you think? Please comment at the bottom of Martha’s story here.