The pandemic destabilized the healthcare system and revealed inefficiencies in how care is provided and regulated. The repercussions of such a once-in-a lifetime, transformational event will be felt for years to come as the system adapts to new challenges relating to telehealth, payment systems, capacity constraints, regulatory burdens, and more.

The most pressing challenge facing the healthcare sector is the growing vacancy rate throughout the care continuum. From an aging workforce, to burnout affecting those currently employed, to the lack of young people entering the healthcare labor market, the system is at a multifactorial crisis point.

Since its enactment in 2010, the Affordable Care Act has faced numerous legal challenges, as well as concerns about the law’s ability to keep healthcare coverage it offers at an affordable level. Issues relating to ACA accessibility, mandated coverage options, as well as changes to federal-state cost-sharing agreements require continuing vigilance at the federal level.

No patient should be stuck in the middle when it comes to their medical bill. The No Surprises Act protects people from receiving out-of-network medical bills when they receive emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers.

It also establishes an independent dispute resolution process for payment disputes between plans and providers, and installs new dispute resolution opportunities for uninsured and self-pay individuals when they receive a medical bill that is substantially greater than the good faith estimate they get from the provider.

Medicare is generally the largest component of a hospital’s line of operation. As such, all aspects of the program – from attempts to cut reimbursements to providers, to issues relating to Medicare Advantage plans, to discussions relating to “entitlement” programs, and even “single-payer” proposals – demand the full attention of our federal officials.  MHA and its membership provide the Massachusetts delegation with insight and real-world examples that help our elected officials influence the federal dialogue on Medicare. 

Providers that care for low-income patients rely greatly on the 340B program, but misguided attempts to destabilize this critical program continue at the federal level. Tackling the pharmaceutical component of the healthcare dollar is a priority of MHA’s work in D.C.