10,000 Deaths, Field Hospitals, Telehealth Co-Pays

A Sobering Statistic: 10,000 Dead in Massachusetts Due to COVID-19

Massachusetts deaths directly attributable to COVID-19 passed the 10,000 threshold last week.
The first coronavirus-related death in Massachusetts was recorded on March 20. The largest one-day total of confirmed deaths was 197 on April 24. Throughout November, COVID-19 has claimed an average of more than 20 Bay Staters each day. More than 240,000 people in the U.S. have died from the virus and average daily deaths across the country are now exceeding 1,000. Most of the deaths (171,000-plus), according to the CDC, have occurred in people over age 65. But all age groups, including those under age 1, have experienced deaths due to COVID-19.
The medical and scientific communities since the pandemic’s outbreak have also begun to track the non-fatal effects of COVID-19, which range from persistent neurological and respiratory problems, to loss of taste and sense of smell, ongoing lethargy, and more.
It seems that many people have become resigned or indifferent to the daily death counts. That attitude in turn exacerbates the spread of the disease. Remaining vigilant about mask wearing, social distancing, and handwashing and hygiene is proven to reduce the spread of COVID-19 and the deaths it is causing.

UMass Memorial Health Care to Lead DCU Field Hospital

Governor Charlie Baker announced on Friday that UMass Memorial Health Care will serve as the clinical leader of a 240-bed field hospital at the DCU Center in Worcester that should be up and running during the first week of December.
The DCU Center hospital and four other field hospitals were created during the spring surge, but only DCU and the one at Boston Convention Center saw regular use. The state said other field hospitals may follow as the need arises.
UMass Memorial Health Care President & CEO Eric Dickson, M.D. spoke at the governor’s conference and stressed the need for everyone to “do the right thing everyday” in terms of mask wearing, social distancing, and hand hygiene, among other proven virus-fighting strategies.
"On behalf of caregivers across the state who ultimately are the ones who are bearing the burden of this disease, and who have to go into rooms and risk becoming infected themselves, please everyone, please follow the rules every day,” Dickson said.

BMC, Circle Health Leaders Reassure Public on COVID-19

While the cases and deaths related to COVID-19 creep up, and the state plans to re-mobilize field hospitals, the healthcare community is better prepared now than it was in the spring to handle the surge. That’s the message Governor Baker and hospital leaders stressed last week.
Last Tuesday, the President and CEO of Lowell General Hospital and Circle Health, Jody White, who is the current chair of the MHA Board of Trustees, joined Boston Medical Center President & CEO Kate Walsh at Governor Baker’s regular pandemic press conference to reassure the public on provider preparedness.
“It is no secret that our communities have seen a rise in COVID-19 cases since Labor Day, and that is now leading to an increase in hospitalizations, raising fears of a possible surge like the one we saw earlier this year,” White said. “On behalf of MHA and my fellow healthcare leaders across the commonwealth, I want to give the residents of Massachusetts a sense of confidence ... We are here for you and you are safe with us.”
Walsh said, “While the rising cases that we are all seeing in our state creates apprehension, and we know not to underestimate this virus, the Massachusetts hospital community is in a very different position today than we were last spring.” Since the first surge, Walsh said, testing capabilities and turnaround time have vastly improved and there is much deeper coordination and sharing of information at the city and state level on testing data. 
“Last spring we were counting [personal protective equipment] in days,” she added. “Now we are counting in months and have a year’s supply of hard-to-acquire items.”
Both hospital leaders urged the public not to defer care out of fear of COVID-19, and stressed the need to get a flu shot to reduce the chance of hospital emergency rooms being overrun by the double hit of flu and COVID-19 cases.
“Our ask – and my ask as a hospital leader and your fellow citizen and a mom – is that we all do our part to stay safe,” Walsh said. “Wear a mask, practice physical distancing and hand hygiene. These public health measures work and together we can save lives.”

Health Insurance Companies Shift Telehealth Burden Back to Patients

Some Massachusetts health insurance companies have begun to remove the assistance they had offered individuals and families during the height of the pandemic and are no longer waiving co-pays and cost sharing for telehealth services.
Waiving co-pays and cost sharing for their members was a benefit to people who were struggling financially or who were concerned about seeking care in facilities during the spring surge. Telehealth additionally allowed providers to preserve personal protective equipment (PPE) and stay healthy themselves. While telehealth boomed during 2020, patient visits overall were down as were insurance claims, allowing the insurance companies to amass great profits.
Now, as the pandemic resurges and people once again seek care through the convenience and safety of telehealth, some insurers have re-imposed cost-sharing for non-COVID telehealth for their Massachusetts customers. Massachusetts health insurance companies will raise premiums next year by 7.9% on average.

MassHealth Extends Telehealth Benefit

MassHealth, the state’s Medicaid program covering about 1.9 million people, last week issued a bulletin that reaffirms and adds clarification to the previous MassHealth guidance that allows providers to deliver health services through telehealth – and to have that treatment covered and reimbursed on par with in-person visits.
Under the state’s policy, rates of payment for services delivered via telehealth will be the same as rates of payment for services delivered via traditional (in-person) methods. One of the main changes between last week’s bulletin and the bulletin it supersedes is that providers are no longer required to include in the patient’s medical record the CPT code for the service rendered via telehealth. MassHealth also provides added detail to clarify allowable reimbursable services under the telehealth policy. The MassHealth telehealth policy is extended through March 31, 2021. In the coming months, the Executive Office of Health and Human Services is expected to engage in a stakeholder process on a long-term telehealth policy.

House Passes State Budget Plan; Senate Releases its Proposal

The Massachusetts House last Thursday passed a roughly $46 billion FY2021 state budget by a 143-14 vote, while on the same day the State Senate’s Ways & Means Committee released its version of the budget that in many ways mirrors the House’s plan.
Both budgets include a withdrawal from the state's "rainy day" fund, with the Senate using $1.5 billion and the House $1.55 billion. Both budgets also provide near identical funding levels for MassHealth and other state healthcare programs, closely following the governor’s revised FY21 recommendation for these line items. FY21 MassHealth program funding is now 10% above the FY20 appropriation, driven largely by enrollment increases as the state continues eligibility protections during the COVID-19 emergency. Enhanced federal Medicaid revenues provided by Congress help to support this funding increase. 
The House approved an amendment sponsored by Rep. Claire Cronin (D – Easton), which is a version of the ROE Act, and which would allow abortions after 24 weeks in the case of lethal fetal anomalies, and lower the age from 18 to 16 for the current judicial bypass process for pregnant patients that can’t get parental consent. The House also adopted an amendment to study the potential implementation of the Nurse Licensure Compact in Massachusetts.
Of particular note, the Senate Ways & Means budget includes $10 million in funding for the creation of new inpatient psychiatric beds to help alleviate the behavioral health/emergency department boarding crisis. Senate debate is scheduled to begin tomorrow, November 17. 
The governor has said he hopes to have a budget from the legislature on his desk by Thanksgiving. And then the process begins all over again; the governor typically files his budget for the upcoming fiscal year (FY22) in January.

Beth Israel Lahey Health and Joslin Diabetes Explore Merger

Beth Israel Lahey Health and Joslin Diabetes Center have signed a non-binding letter of intent to explore opportunities for Joslin to join BILH. If the deal goes through, Joslin would become a full member of BILH, according to a press release from the two entities. Such a merger would entail state and federal regulatory review. 

MHA’s Women’s Conference Focuses on Self-Care 

Female healthcare leaders from across Massachusetts gathered virtually last Thursday to attend MHA’s Annual Women Leaders in Healthcare Conference, entitled Leadership Redefined. 
In a video greeting to kick off the event, Massachusetts’ Secretary of Health and Human Services Marylou Sudders thanked MHA “for ensuring a strong, unified voice for our hospital and healthcare community in Massachusetts.”
Sudders also praised current and aspiring women healthcare leaders in the commonwealth for their dedication and resilience and urged conference attendees to tackle current challenges firmly while remembering their own wellbeing. 
“During this extraordinary and challenging time – a pandemic, increasingly rancorous political divides, and an inflection point, confronting structural racism in our country once and for all – we must find our strength, and to do so with resolve,” Sudders said. “And to do so, ladies out there, you must also take care of yourself.”
Among the many dynamic speakers was Lashyra “Lash” Nolen, Harvard Medical School’s first Black woman class president, and Suzanne Bates, CEO of Bates Communications, who led attendees through a workshop on negotiation tactics and how to gain self-confidence by focusing on what she described as women’s strong problem-solving skills. 
Emerson Hospital President & CEO Christine Schuster, R.N., led a wide-ranging panel discussion on resilience and self-care lessons learned during the pandemic with three senior female hospital leaders: Nancy Gaden, R.N., SVP and CNO at Boston Medical Center; Cheryl Lapriore, SVP, chief of staff, UMass Memorial Health Care; and Deborah Bergholm-Petka, director of organizational development, Circle Health/Lowell General Hospital. 
Other speakers included Hiyam Nadel, R.N., nursing director in the Department of Obstetrics and Gynecology and director of the Center for Innovations in Care Delivery at Massachusetts General Hospital; and Hannah Ubl, co-founder of Good Company Consulting and a communication and culture expert.
Massachusetts Women’s Forum President Jackie-Jenkins Scott moderated a “fireside chat” on mentorship with Sandra L. Fenwick, CEO of Boston Children's Hospital, and Patrice A. Harris, M.D., immediate past-president of the American Medical Association. Both Fenwick and Harris noted their deep concern about the loss of a large percentage of women in the U.S. workforce due to pandemic. 
“Economic issues, the lack of quality affordable options for our children the fact that a big group of us are truly members of a sandwich generation … what we are trying to do as women is becoming more and more challenged,” Fenwick said.

Leveraging ACOs and Value-Based Care in Healthcare’s New Normal

Thursday, December 3, 2020; 8:30 to 11 a.m.


ACOs and value-based care models are moving forward despite the frequent changes in government and regulatory policies. Providers have kept their eyes on the ball and pushed care to ambulatory settings, re-focused resources, and, in recent months, transformed to telemedicine almost overnight. At this program we’ll take a look at the current challenges, concerns, and successes in providing the best care to patients at the most affordable costs. We’ll look at the potential effects of the telemedicine revolution and what the near future may hold for value-based care and successful models for providers.
Click here to see the line-up of speakers and to register for this virtual program.

John LoDico, Editor