Provider news: the latest in health care headlines
Published by
Mass General Brigham Health Plan blog team
on
Skim a cross-section of medical news from Massachusetts, New Hampshire, Rhode Island, and across the U.S.
In this issue
Headlines from Massachusetts
- Gov. Baker testifies on healthcare legislation, pushes for focus on primary care, mental health
- Mass. officials seek to control urgent care industry
- Healthcare organizations in Central Mass. cutting executive positions, pay Boston hospitals plan to provide 'Farmacy' prescriptions for veterans in need
- Partners HealthCare aims to spend $6.1B over five years on expansions
- AllWays Health Partners provider survey finds almost 80% satisfied with customer service experience
Headlines from New Hampshire
- New Hampshire Hospital CEO will lead New Hampshire Health Department
- With state funding, N.H. hospitals add mental health beds
- Dartmouth-Hitchcock Health, GraniteOne Health make the case for their merger
- Health initiative making the rounds in R.I. schools
- R.I. establishes state task force on coronavirus
- Health insurance mandate takes effect in R.I.
- R.I. health initiative aims to address care disparities, improve factors that affect well-being
- Community Provider Network of RI gets advocacy award from RI Foundation
National headlines
- Half of doctors would take less pay for fewer hours, better work-life balance
- U.S. sees second wave of flu outbreak
- CMS ratings may penalize hospitals serving disadvantaged neighborhoods due to social risk factors
- Verma: Amount of ACOs taking more risk doubles under Pathways To Success program
- Rural America doctors at the frontline of opioid addiction and pain
- Cedars-Sinai expands thresholds for free medical care
- Stanford Medicine report notes the rise of the data-driven physician
- Providers suffering trauma from treating mass killings
- Portals can place strain on physician-patient relationships, study finds
- Physicians spend about 16 minutes per patient on EHRs, study finds
- Providers adopting new models to address primary care gaps
- Health systems will spend $2.5B more on drugs throughout the next year, Vizient says
Massachusetts
January 28, 2020
Gov. Baker testifies on healthcare legislation, pushes for focus on primary care, mental health
Gov. Charlie Baker called for mandates to increase the amount of money providers and insurers spend in two critical areas: primary care and mental healthcare. Mass. officials estimate about 11% to 15% of healthcare dollars in the state are spent on primary care and mental healthcare. The governor's plan would require insurers and providers to increase their current spending in these areas by 30% over three years. To keep costs in check, the administration would require insurers and providers to continue to adhere to the state's overall healthcare spending benchmark, which requires they keep their growth in spending to 3.1% per year.
The Boston Globe (sub. req.)
January 20, 2020
Mass. officials seek to control urgent care industry
Mass. policymakers want to impose requirements on urgent care centers. The lack of standards means any provider can market itself as "urgent care," and patients don't know what to expect when they walk in the doors, said Marylou Sudders, the state's secretary of health and human services. The Baker administration wants these centers to be licensed as clinics, to provide care to low-income patients who use MassHealth and to offer some mental health services. State lawmakers have filed more than a dozen bills pertaining to urgent care centers this session, and both House and Senate are working on additional legislation that is likely to include regulations for the industry. Operators of urgent care clinics say such regulation could slow growth or even kill an industry that provides convenient, affordable care.
The Boston Globe (sub. req.)
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January 6, 2020
Healthcare organizations in Central Mass. cutting executive positions, pay
Faced with declining patient discharge numbers and seeing a chance to pare costs that didn't affect patients, UMass Memorial Health Care in Worcester cut much of its executive ranks. Executive pay totaled more than $31 million the year Eric Dickson, UMass Memorial president and CEO, took over in 2013. By 2017, total executive pay fell below $15 million. UMass Memorial eliminated positions that became redundant with consolidation. UMass Memorial Health Care also reduced the number of employees by almost 8% over a five-year period ending in 2017. Over the last five years, other healthcare employers in Central Mass. adopted a similar cut-at-the-top model, according to a Worcester Business Journal examination of filings with the IRS:
• Fallon Health executive compensation dropped 18% while the insurers total workforce grew 9%;
• Heywood Hospital in Gardner trimmed its total executive compensation 2% while adding 9% more staff in the last five years; and
• Milford Regional Medical Center also cut executive payroll, from more than $2 million to under $900,000 in one year. That comes as the hospital’s workforce rose 13%.
Worcester Business Journal
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January 27, 2020
Boston hospitals plan to provide 'Farmacy' prescriptions for veterans in need
Veterans Administration Repurposing Agriculture for Nutrition and Diet Awareness (Varanda) will create a network of food gardens at veterans' hospitals to provide free, fresh food to vets and their families. The program is slated to start this year in the Boston suburbs Brockton and Bedford. Funding will come from private donations, federal and foundation grants and existing VA reimbursement mechanisms. Varanda is intended to become a preventive health initiative that includes a food pantry, sustainable produce garden and a farmer's market for veterans and their families. The goal is to supply over 5,000 pounds of fresh produce from April to November and be supplemented by food from the Greater Boston Food Bank for year-round distribution.
U.S. News & World Report
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January 13, 2020
Partners HealthCare aims to spend $6.1B over five years on expansions
At the JPMorgan Healthcare Conference, Partners HealthCare laid out a roadmap to grow and compete in the coming years, with plans to spend $6.1 billion over the next five years on capital projects and expand in New England and abroad. Partners CEO Anne Klibanski and CFO Peter Markell detailed several initiatives and financial plans. Between FY2020 and FY2024, Partners plans to spend $6.1 billion in both committed projects and new initiatives and could be higher. Partners says it has another $675 million available. Planned capital spending includes a $250-million expansion at Brigham and Women’s Faulkner, a $58-million expansion at Newton-Wellesley Hospital, a $1-billion new building at Massachusetts General Hospital, as well as several multi-million dollar investments in digital health. Executives also outlined plans for three new outpatient care sites - in Westborough, Woburn, and Salem, NH - as well as the expansion of two others - in Westwood and Portsmouth, NH. As part of its plans to rebrand into Mass General Brigham, the organization will expand digital health initiatives and innovation, develop national and international business opportunities, and find new revenue streams, such as commercializing discoveries of Partners' faculty.
Boston Business Journal
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January 21, 2020
AllWays Health Partners provider survey finds almost 80% satisfied with customer service experience
AllWays Health Partners shared results from its annual provider satisfaction survey to measure the experiences of its network, stating that it received responses from more than 800 providers. Survey findings include:
• Nearly 85% of providers gave a satisfied rating overall, up 10% from 2018, while 40% more providers rated AWHP as "very easy" to work with over any other health plan;
• Over 80% of providers were "satisfied" or "very satisfied" with authorization turnaround times;
• Nearly 80% of providers were "satisfied" or "very satisfied" with customer service experience, and nearly 85% were "satisfied" or "very satisfied" with the ease of claims; and
• Over 80% of providers were "satisfied" or "very satisfied" with its Provider Portal.
AllWays Health Partners Blog
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New Hampshire
January 22, 2020
New Hampshire Hospital CEO will lead New Hampshire Health Department
The head of New Hampshire's state psychiatric hospital has been approved by the Executive Council to be the next commissioner of the Department of Health and Human Services. Gov. Chris Sununu nominated Lori Shibinette to replace Jeffrey Meyers, who stepped down to pursue private-sector work. Shibinette has been the CEO at the New Hampshire Hospital. A registered nurse, she previously served as deputy commissioner at Health and Human Services and as CEO of the Merrimack County Nursing Home.
WCAX
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January 6, 2020
With state funding, N.H. hospitals add mental health beds
Portsmouth Regional Hospital and Parkland Medical Center in Derry have announced they are adding a combined eight inpatient psychiatric beds. Amidst an ongoing lawsuit over that issue, lawmakers last year passed additional funding for mental health beds in the state. Portsmouth Regional Hospital and Parkland Medical Center, both owned by the for-profit Hospital Corporation of America, are the first to take the state up on that funding. The beds also come roughly a month after the latest report from the expert reviewer for the New Hampshire Community Mental Health Agreement. That agreement, born out of a separate lawsuit, requires the state to provide more community-based mental health services to avoid unnecessarily institutionalizing mental health patients. According to the expert reviewer, the state remains in non-compliance with the agreement, five years after it took effect.
New Hampshire Public Radio
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January 7, 2020
Dartmouth-Hitchcock Health, GraniteOne Health make the case for their merger
In a filing with the N.H. attorney general’s Charitable Trusts Unit, Dartmouth-Hitchcock Health says it needs to combine services with Catholic Medical Center and its affiliated hospitals to gain access to more patients, protect the state's only academic medical center from out-of-state competitors and shore up rural hospitals. D-HH and GraniteOne Health add that keeping patients in-state will keep costs down and be more convenient for patients and families. Otherwise, academic medicine in southern N.H. "will be ceded to the likes of Mass General Brigham with cascading recessionary effects on D-HH’s academic mission," the organizations argue. The combined organization would be known as Dartmouth-Hitchcock Health GraniteOne. It would expand specialty care at CMC and to GraniteOne’s rural hospitals. PYA. a consulting firm hired by the two systems estimated the combined organization could save between $12.5 million to $32 million over three years. The Charitable Trusts Unit review is scheduled to be completed by April 28. The health systems also need approval from the state Consumer Protection Bureau and the Federal Trade Commission.
Valley News
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Rhode Island
January 16, 2020
Health initiative making the rounds in R.I. schools
A new health initiative, called Change Direction, is making the rounds in R.I. schools. The Hospital Association of RI, along with the RI Department of Health and RI Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals, partnered to bring this mental health campaign to the schools. At Nathanael Greene Middle School in Providence, signs around the school show the five signs that may indicate someone isn't emotionally well. The five signs that indicate something might not be right is being addressed in the classroom, and in practice. The Hospital Association of RI said this program is in 10 school districts so far and they're hoping to expand its reach.
Turn to 10
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January 28, 2020
R.I. establishes state task force on coronavirus
The R.I. Department of Health established a task force to coordinate preparedness for the coronavirus. The department said it would maintain a system to receive and follow up on illness reports from providers in the state and has regularly disseminated summaries of the national situation to providers. It has also provided criteria to evaluate patients, and information on collecting specimens, testing and reporting. The Novel Coronavirus Task Force includes leaders from the State Health Laboratories, the Center for Acute Infectious Disease Epidemiology, and the Center for Emergency Preparedness and Response.
The Westerly Sun
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January 1, 2020
Health insurance mandate takes effect in R.I.
Rhode Island residents must now have health insurance or face a penalty on their taxes. Residents who don’t have minimum essential coverage in 2020, and do not qualify for an exemption, will face a penalty next year when filing a state tax return for 2020.
Turn to 10
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January 20, 2020
R.I. health initiative aims to address care disparities, improve factors that affect well-being
The Rhode Island Foundation unveiled an unprecedented statewide plan that seeks improvements in healthcare and in the educational, economic, social, environmental and other factors that affect individual and group health in the state. Achieving health equity by resolving racial, ethnic, income and gender disparities is another objective of Health in Rhode Island: A Long Term Vision. The philosophy underpinning the vision is the understanding of the importance of social determinants and influences that lie outside of the traditional providers of healthcare.
Providence Journal (sub. req.)
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February 3, 2020
Community Provider Network of RI gets advocacy award from RI Foundation
The Community Provider Network of Rhode Island (CPNRI) received the Advocacy Award from the Rhode Island Foundation. The organization received the award for its work leading the Stable Workforce, Stable Lives public education campaign. The program led to a $.91 cent wage increase for Direct Support Professionals (DSP) who support Rhode Islanders with intellectual and developmental disabilities living in the community. The Stable Workforce, Stable Lives campaign included community forums, developing and releasing six advocacy videos, producing a policy brief outlining relevant data and priorities and publishing an advocacy guide to prepare new leaders for meetings with policymakers.
Go Local Prov
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National
January 16, 2020
Half of doctors would take less pay for fewer hours, better work-life balance
Half of physicians said they would take a salary reduction of up to $20,000 per year in exchange for working fewer hours and achieving a better work-life balance, according to a Medscape survey (reg. req.). It found Millennials (52%), Generation Xers (48%) and Baby Boomers (49%) would take a salary cut in exchange for more personal time. Some 53% of women said they would take a pay cut, versus 47% of men. Boomers would give up more money than younger doctors, with 12% willing to take a cut of $50,001 to $75,000 and 6% willing to reduce their pay by more than $75,000 to work 20% fewer hours. While burnout was down, doctors in Gen X (ages 40-54) experienced a higher rate of burnout than Millennials (ages 25-39) or Baby Boomers (ages 55-73).
Fierce Healthcare
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January 31, 2020
U.S. sees second wave of flu outbreak
The CDC estimates that more than 19 million Americans have fallen ill with the flu so far this season, including 180,000 who ended up in the hospital. About 10,000 Americans have died, including more than 60 children. This flu season in the U.S. began earlier than usual. It started picking up in mid-November with a surge of influenza B, a strain that typically develops later in the cycle and hits children the hardest. But an increase in new flu infections began to appear over the past two weeks. The strain that is emerging is an H1N1 type of influenza A, the one that normally kicks off the season. It can take hold in adults and may be more severe, resulting in more deaths.
The Boston Globe (sub. req.)
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January 7, 2020
CMS ratings may penalize hospitals serving disadvantaged neighborhoods due to social risk factors
Hospital ratings are intended to help patients decide where to get medical care and encourage hospitals to improve the quality of their services. They also can influence how insurance companies negotiate contracts for reimbursing hospitals. But a University of Chicago Medicine analysis of CMS Hospital Compare rating system shows hospitals serving vulnerable communities may be judged on social risk factors (SRFs) outside of their control. The results showed hospitals caring for patients in neighborhoods with higher SRFs had lower quality scores in areas hospitals may have little control over. The impact of neighborhood SRFs was most evident in scores for timeliness of care, hospital readmissions and patient experience. While scores in safety, efficiency and effectiveness of care were minimally affected by SRFs.
University of Chicago
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January 10, 2020
Verma: Amount of ACOs taking more risk doubles under Pathways To Success program
CMS Administrator Seema Verma said 192 ACOs are starting 2020 by taking on downside financial risk, which means they must pay back CMS if they do not meet savings targets. That is double the 93 ACOs taking on risk at the start of 2019. Verma was also enthusiastic that the number of physician-led ACOs grew to 270 as of Jan. 1, a 27% increase from a year ago. Verma also reported that next-generation ACOs, which take on a high amount of financial risk, generated more than $184 million in savings for Medicare in 2018.
Health Affairs
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January 10, 2020
Rural America doctors at the frontline of opioid addiction and pain
Drug overdose deaths are more common by population size in rural areas than in urban ones. Amid a nationwide decline in prescribing rates since 2012, rural doctors prescribe opioids more often by far. Rural Americans have fewer alternatives to treat pain, and they disproportionately lack access to effective addiction medication. It used to be rare for primary care physicians outside big cities to take on the challenges of opioid misuse, according to Dr. Erin Krebs, a professor of medicine at the University of Minnesota who researches chronic pain management. Krebs said it's becoming increasingly common "out of necessity." Both pain management and addiction treatment are specialties, calling for advanced training that many family physicians don't have. For rural physicians, the burden of responding to the opioid epidemic falls squarely on their already loaded shoulders.
Kaiser Health News
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January 3, 2020
Cedars-Sinai expands thresholds for free medical care
Effective Jan. 1, Cedars-Sinai Medical Center in Los Angeles loosened the income cap for patients to qualify for free or discounted care. It will expand eligibility for free medical care to patients with household incomes up to 400% of the federal poverty level: $49,960 for an individual and $103,000 for a family of four. It will also expand access to discounted care to those with incomes up to 600% of the federal poverty level. The hospital said it's making the change because it's treating more patients who are "underinsured" because they have health insurance plans with high deductibles, copayments or other out-of-pocket costs.
CaliforniaHealthline
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January 9, 2020
Stanford Medicine report notes the rise of the data-driven physician
Physicians are preparing for the transformation of patient care due to the increase in digital technologies, according to the 2020 Health Trends Report by Stanford Medicine. The survey's findings include:
• Physicians, residents, and students expect almost a third of their duties could be automated by technology in the next 20 years;
• Nearly half of all physicians (47%) and three-quarters of medical students (73%) are seeking out additional training to better prepare themselves for innovations in healthcare;
• A majority of students and residents (78%) and physicians (80%) say self-reported data from a patient's health app would be clinically valuable in supporting their care;
• When asked to rate the effectiveness of their education to prepare them for these developments, only 18% of current medical students and residents surveyed said that their education was "very helpful," while 44% of physicians surveyed said that their education was either "not very helpful" or "not helpful at all;" and
• Among physicians and residents, nearly one in five would change their career path if they were given the opportunity to do so, citing poor work-life balance and administrative burdens as the top reasons for reconsidering a medical career.
Stanford Medicine
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January 3, 2020
Providers suffering trauma from treating mass killings
A team of researchers with the Schwartz Center for Compassionate Healthcare is studying the experiences of U.S. clinicians who have treated victims of mass shootings, mining for insights to buoy a workforce routinely exposed to trauma. Across all fields of medicine, nearly 15% of physicians experience PTSD, with 40% of trauma surgeons exhibiting the symptoms. In a study of doctors who had treated bomb victims, one in four were diagnosed with PTSD. A study of inpatient nurses found 18% met the diagnostic criteria for PTSD. These traumas are felt by people working in an industry with the highest level of depression in the nation. For providers, this pain may manifest as burnout. In nursing, it's called compassion fatigue.
STAT
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January 8, 2020
Portals can place strain on physician-patient relationships, study finds
Interviews with primary care physicians and department heads found patient portals have a positive effect on relationships with patients - but also change expectations patients have about those relationships, researchers reported in JAMA Network Open. The study found patients want faster responses to portal messages, creating added pressure on clinicians and prompting them to develop workarounds and strategies to relieve that stress.
Patient Engagement HIT
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January 14, 2020
Physicians spend about 16 minutes per patient on EHRs, study finds
Physicians spend on average just over 16 minutes on EHRs for each patient visit which adds up to a significant portion of a physician's day, according to a Cerner study in the Annals of Internal Medicine. The study found they spend an average of 16 minutes and 14 seconds per patient encounter using EHRs, with chart review (33%), documentation (24%) and ordering (17%) accounting for most of the time. The study found the time spent on EHRs varied greatly by specialty. For instance, doctors in gerontology, endocrinology, primary care and internal medicine had the highest times per encounter of up to 18 to 22 minutes. Sports medicine and physical medicine and rehabilitation (at eight and 10 minutes per patient) were much lower. Doctors also spent 11% of the time on EHRs either on weekends or after 6 p.m. or before 6 a.m.
Fierce Healthcare
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January 28, 2020
Providers adopting new models to address primary care gaps
To address primary care gaps and other issues, a number of health systems are adopting new concierge-like approaches for primary care through in-house services and partnerships to reduce hospitalizations, lower costs, and reduce medical complications. For example:
• Advocate Aurora Health in Ill. is partnering with privately owned company Oak Street Health to open a high-touch clinic for seniors living in Chicago. Oak Street Health uses capitated or full-risk models to offer Medicare, Medicare Advantage, Medigap and Medicare-Medicaid beneficiaries tailored care;
• ChenMed, a Miami-based primary care company, offers patients lifestyle classes, imaging, labs and acupuncture, same-day appointments, transportation, unlimited visits, medication dispensing and on-site acupuncture, cardiology, imaging and labs.
• Castell, a company recently spun off by Intermountain Healthcare, offers affiliated network management guidance, data analytics, and other best practice services, in an effort to deliver value-based preventive primary care. Intermountain said its Reimagined Primary Care has allowed physicians to spend more time with high-risk patients to address potential health issues, reduce hospitalizations and cut costs; and
• Other health systems, including Johns Hopkins Medicine, Mount Sinai Health Systems, Stanford Medicine and UnityPoint Health, have launched models similar to Intermountain's.
Advisory Board Company
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January 29, 2020
Health systems will spend $2.5B more on drugs throughout the next year, Vizient says
A Vizient report predicts that health systems will face a 3.59% increase in drug spending from July 1 to June 30, 2021, contributing more than $2.5 billion in additional spending. Specialty medicines will continue to drive hospital drug spending, according to the report.
Becker's Hospital Review
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