INSIDE THE ISSUE

> Dementia Care Guidance
> DSH Cuts
> State Budget Signed
> Sturdy & Tufts Partnership
> Mass. Health Leadership College
> Behavioral Health Toolkit Webinar

MONDAY REPORT

CMS Releases New Care Model for Those with Dementia

The Centers for Medicare and Medicaid Services (CMS) has released the Guiding an Improved Dementia Experience (GUIDE) Model to help people living with dementia as well as their unpaid caregivers.

The model includes care coordination and management tools, caregiver education and support, and respite services, all designed to help people remain in their homes and communities. The model will be tested through the Center for Medicare and Medicaid Innovation.

Through the GUIDE Model, CMS will test an alternative payment for participants that deliver certain supportive services to people with dementia. Under the model, participants will assign people with dementia and their caregivers to a care navigator who will help them access services and supports, including clinical and non-clinical services such as meals and transportation through community-based organizations.

“We know that Black, Hispanic, and Asian Americans, Native Hawaiian, and Pacific Islander populations have been particularly disadvantaged in receiving dementia care,” said CMS Administrator Chiquita Brooks-LaSure. “The GUIDE Model will provide new resources and greater access to specialty dementia care in underserved populations and communities.”

A GUIDE Model overview document from CMS is here.

Senators Sound the Alarm Over DSH Cuts

More than half the U.S. Senate recently wrote to Majority Leader Chuck Schumer (D-NY) and Minority Leader Mitch McConnell (R-KY) to share concerns over looming cuts to the disproportionate share hospital (DSH) program. The Medicaid DSH program was established in 1981 to support hospitals providing care to a large volume of patients on Medicaid or without health insurance. The federal funding has ensured these hospitals can remain financially viable despite their receiving lower reimbursement from insurers.

The planned cuts – equating to $8 billion starting on October 1 – date back to the installment of the Affordable Care Act, when it was assumed that increased coverage would eventually eliminate the need for the additional DSH hospital support. “Those coverage levels have not been fully realized yet these hospitals continue to care for uninsured and underinsured patients,” explained the group of senators, which included Elizabeth Warren and Ed Markey of Massachusetts.

The letter continued: “cuts of this magnitude could undermine the financial viability of hospitals, threatening access to care for the most vulnerable Americans. It is essential that we continue to protect those who have come to rely on the services provided by Medicaid DSH hospitals.” Senators are urging legislative action to prevent the funding drain, which would also total $8 billion in each of the three years following FY2024.

State’s FY2024 Budget Signed with Workforce at the Forefront

Governor Healey last Thursday signed a $56 billion budget to fund state spending in FY2024. As previously reported, the budget includes significant appropriations for workforce development, such as tuition support and financial aid, access to free community college, and $192 million in initiatives to build the behavioral health (BH) workforce. Twenty-five million is also devoted for a scholarship program for BH providers in high-need settings.

“This budget’s focus on workforce is exactly what our healthcare system needs right now,” said MHA President and CEO Steve Walsh. “We commend the legislature and Healey-Driscoll administration for their commitment to making education more attainable for aspiring caregivers, keeping talented professionals in behavioral health, and widening the doors of entry into the healthcare field. These investments are in lockstep with our healthcare organizations’ around-the-clock efforts to grow and develop the caregiving profession in Massachusetts.”

Sturdy Health and Tufts Medicine Form New Partnership

Last week, Sturdy Health and Tufts Medicine announced a new clinical partnership aimed at further streamlining care for their patients. The affiliation will focus specifically on coordinating specialty care, beginning with cardiovascular services, and allow the systems to “jointly recruit” and grant privileges to physicians and surgeons.

“This clinical partnership further expands our ability to provide the highest quality care in the communities we serve as an independent, locally owned and operated non-profit health system,” said Aimee Brewer, Sturdy Health’s president and CEO.

“We look forward to providing a streamlined pathway to well-coordinated, complex care services to Sturdy Health and their patients,” said Michael Tarnoff, M.D., CEO of Tufts Medical Center.

Sturdy Health will maintain its existing clinical partnerships with Boston Medical Center, Shields Health, and Mass General Brigham.

The Massachusetts Health Leadership College Accepting Applications

MHA has opened applications for the 2024 Massachusetts Health Leadership College, which is run in collaboration with Harvard Business School.

The Leadership College equips participants with essential skills, knowledge, coaching, and invaluable networks needed to lead healthcare organizations confidently into the future. Since its inception, the Leadership College has produced 120 graduates across 41 organizations; eight graduates have gone on to fill president and CEO roles.

The program runs from April to October 2024, and consists of monthly leadership forums, three-day residential immersive learning experience at Harvard Business School, and individual coaching and assessment by the business school’s experts. Topics covered include leading during transformation, inclusive leadership, agility, digital transformation, decision-making under uncertainty, strategy development, and leading teams.

The program is designed for current and future C-suite executives, as well as high-potential leaders at the senior vice president, vice president, and director levels, and is available to clinical, non-clinical, and administrative leaders. MHA strongly encourages participation from diverse individuals across all leadership tracks.

The deadline for registration is October 31, 2023. Details about registration, costs, and your contact for more information is included in the brochure linked to above.

MHA-MassHealth Webinar on Behavioral Health Toolkit

The consultant MassHealth engaged to support the implementation of the Behavioral Health Roadmap, Health Management Associates (HMA), hosted regional meetings earlier this year for emergency departments (EDs) and Community Behavioral Health Centers (CBHCs) to provide technical assistance on behavioral health crisis evaluations in EDs, disposition support for crisis intervention and follow-up services, and other services outlined in the state’s Roadmap for Behavioral Health Reform.

As a result of feedback that MHA, hospitals, and CBHCs provided, and to continue supporting transitions of care between EDs and CBHCs, HMA developed a Community Behavioral Health Center & Emergency Department Care Transitions and Partnerships: Technical Assistance Tool Kit containing information about available community-based services, including bi-directional workflows and patient access points.

In partnership with MassHealth and HMA, MHA will be hosting a webinar on Friday, September 15 with more information on the toolkit and community-based services, including new Youth Community Crisis Stabilization (YCCS) and transitions to care. The webinar is geared to core ED medical, behavioral health, and case management leadership and frontline staff, including sub-contractors, who conduct BH crisis evaluations, and who regularly work with BH patients in the ED and/or who work on patient disposition and transitions of care, particularly patients who will be referred to CBHCs. Register for that webinar here.

John LoDico, Editor