Anti-Ratio Website, Flu, Warren on 340B, and more...

Website To Defeat Nov. Ballot Question Goes Live

The Coalition to Protect Patient Safety – organized to mobilize opposition to the November ballot question on government-mandated nurse staffing ratios – launched its website last Monday. Visit the website here.

One nursing union, representing less than 25% of the nurses in the state, is promoting a ballot question that would require every hospital to adopt rigid, one-size-fits-all, R.N.-to-patient ratios at all times – regardless of a hospital’s size, location, or the needs of patients.

The Coalition to Protect Patient Safety website lays out the facts about how mandated ratios will adversely affect patient care. The website contains, among other items, video testimonials from frontline nurses across the state who are opposed to mandated ratios, as well as ways the public can get involved in the campaign.

California is the only state that has implemented nurse staffing mandated ratios, and there is no evidence that those mandates have increased the quality of care patients receive.

The nursing union that has attempted to impose ratios in Massachusetts over the past 20 years has been consistently opposed by healthcare leaders – doctors, nurses, policy makers, and others – who feel that arbitrary ratios ignore that not all healthcare is the same; that patients have different needs, nurses have different experience and education, and that the composition of care teams is always changing and that each hospital has its own abilities and constraints.

The Coalition to Protect Patient Safety is currently made up of MHA, the Organization of Nurse Leaders, ANA Massachusetts (the local chapter of the American Nurses Association), the Massachusetts Council of Community Hospitals, and the Conference of Boston Teaching Hospitals. Numerous Chambers of Commerce have endorsed the coalition’s effort. Check the website’s “Supporters” tab for regular updates of supporters.

Judge: Anti Flu-Shot Argument Not Valid

As Massachusetts hospitals deal with one of the worst flu seasons in recent memory, they received some good news last week when a Suffolk Superior Court judge threw out a Massachusetts Nurses Association lawsuit that challenged Brigham and Women’s Hospital’s mandatory flu vaccination policy for employees.

A number of hospitals in Massachusetts require caregivers to receive flu vaccines each year, unless they have a medical or religious exemption, in which case the healthcare worker needs to wear a face mask in the presence of patients. All hospitals in the commonwealth strongly encourage their workers to get vaccinated and offer free flu vaccine to their employees.

As a recent DPH survey showed (see story above) staff sicknesses reverberate through the hospitals resulting in overworked colleagues, overtime pay, and the use of travel nurses.

For years, the MNA has tried to make one non-starter argument after another against mandatory flu vaccination, garnering strong opposition as far back as 2014 from members of the general public and physicians, who de-bunked the union leadership’s incorrect claims that there were a number of adverse events related to flu vaccine – when in fact serious health risks due to flu vaccine is rare. The nurses’ union’s latest objections – that mandatory vaccination is an overreach and unfair given that the vaccine sometimes has limited efficacy – didn’t hold water with the judge or with medical professionals.

“Getting a flu shot is safe, it’s the best way to protect against the influenza virus, and it can prevent unnecessary anxiety and waste of healthcare resources,” said MHA’s V.P. of Clinical Integration Steve Defossez, M.D.  “As healthcare providers, our members are responsible for promoting public health and should be role models. As centers for care, hospitals will continue to be proactive in ensuring the safest conditions possible for their patients, families, and healthcare professionals alike.”

Warren Defends 340B Program at Senate HELP Hearing

Sen. Elizabeth Warren (D-Mass.) defended the 340B drug program and the hospitals and health centers that rely on it at a hearing last Thursday before the Senate Health, Education, Labor and Pensions (HELP) Committee on which she sits.

The 340B Drug Discount Program requires drug companies to provide discounts to safety net hospitals and health centers.  Providers like the program – indeed, some say they need it to survive financially – because it allows them to stretch federal dollars to maintain services for their low-income patients and communities.  Drug companies argue that not all hospitals taking advantage of the 340B merit the discounts.

At Thursday’s hearing, Warren noted that the sum total of discounts the pharmaceutical industry provided to hospitals and health centers in 2015 was about $6 billion on total drug company revenue of about $775 billion.

“It is clear that the total loss to these drug companies – the loss that that they’re kicking and screaming about right now – is a tiny fraction of the many billions of dollars that they pull down every year in profits,” Warren said. She noted that the average drug company profit margin in 2017 was 17.1%.

The 17.1% margin was six times the average margin of the hospitals he represents, according to testimony provide by Bruce Siegel, M.D., the president & CEO of America’s Essential Hospitals. Sue Veer, president & CEO of Carolina Health Centers, said her facility operates at a margin of between 1 and 3% “at best” and without 340B the margin would drop to “negative double digits.”

The 2018 Patient Safety Congress

The Institute for Healthcare Improvement/National Patient Safety Foundation (IHI/NPSF) Patient Safety Congress is one of the year’s most important events for healthcare professionals working to shape smarter, safer care for patients. This year’s Congress takes place Wednesday, May 23 through Friday, May 25, at the Hynes Convention Center on Boylston St. in Boston. The 2018 Patient Safety Congress is the first since the National Patient Safety Foundation merged with the Institute for Healthcare Improvement. Staff of all MHA member organizations can save 10% on registration by using the following member code: MASS10. Complete registration materials are here.

Knowledge Sharing Session on Telehealth, Behavioral Health

The Health Policy Commission is hosting a peer-to-peer knowledge sharing session on strategies for using telehealth to support behavioral health integration in primary care settings. The event will consist of a panel presentation, including representatives from Pediatric Physicians’ Organization at Children’s, Yogman Pediatric Associates, and Health Management Associates. Panelists will discuss tele-behavioral health models and operational considerations for getting started with them. The event will take place at the MHA Conference Center in Burlington. Click here for registration and event details.

The National Compassionate Caregiver of the Year Award

The deadline for nominating an individual or team for the Schwartz Center’s National Compassionate Caregiver of the Year Award is March 30. Since 1999, the Schwartz Center for Compassionate Healthcare has honored healthcare professionals who display extraordinary devotion and compassion in caring for patients and families. Award finalists are chosen by a national review committee, which includes past award recipients, and representatives from the American Cancer Society, American Diabetes Association, and American Heart Association/American Stroke Association.  Nomination information is here.


A story in last week’s Monday Report on the much-derided Anthem insurance company policy of denying claims from patients who show up in emergency rooms with conditions that the insurer later determines not to be emergent, stated that Anthem does not have a presence in Massachusetts. However, UniCare, which is owned by Anthem, offers several indemnity plan options to state employees, retirees, and municipalities through the Group Insurance Commission. UniCare provides administrative services only, as the GIC is self-funded. We regret the error.

John LoDico, Editor