INSIDE THE ISSUE

> Hospitals by the Numbers
> Expansions, Affiliations
> Telehealth and Paxlovid
> SCOTUS and Roe
> Imaging Contrast

MONDAY REPORT

National Hospital Week: Massachusetts Hospitals by the Numbers

Hospitals and the workers they employ were battered during the pandemic and are still feeling the effects of COVID-19. But they never wavered in their commitment to caring for patients affected by the pandemic and surely helped prevent thousands of COVID-related deaths in Massachusetts alone.

Here are a few numbers to keep in mind during this week and beyond.

Annual Utilization of Hospitals in Massachusetts:

Discharges from Hospitals: 749,282
Total Patient Days: 3,823,673
Babies Born: 96,286
Emergency Department Visits: 2,631,310
Outpatient Visits: 13,982,211
Utilization data from FY2020 (latest available) from Center for Health Information & Analysis (CHIA)

Workforce Metrics in Massachusetts:

Number Employed at Hospitals: 197,000
Number Employed in Healthcare Sector: 625,300
Compare to Number Employed in Construction, 159,000; Number Employed in Retail; 329,400
All above numbers February 2022 U.S. Bureau of Labor Statistics

Federal Research Dollars Coming to Massachusetts:

National Institutes of Health: $3.2 billion
Centers for Disease Control and Prevention: $583 million
National Science Foundation: $559 million
Agency for Healthcare Research and Quality: $15 million
Total: $4.45 billion
All FY2020 totals from respective agencies

Acute Care Hospital Payer Mix:

Medicare: 42%
Medicaid: 17%
Private Payer: 34%
Other State: 3%
Other: 3%
FY2020 data from CHIA

Health Safety Net:

Massachusetts has the lowest rate of uninsured residents in the nation. For low-income patients that remain uninsured and for those that are underinsured, Massachusetts has a Health Safety Net that reimburses care provided at hospitals and health centers. Hospitals help fund the safety net through a $165 million annual assessment. Hospitals also bear the entirety of any shortfall between the cost of caring for patients and the funds available in the Health Safety Net. As of April 2022, the shortfall is estimated at $70 million.

Community Benefits:

Massachusetts hospitals offer a wide range of services outside of their walls that help build and support the cities and towns they serve, and individuals from all walks of life. In many instances, these services would be otherwise unavailable. These hospital “community benefit programs” – provided at no cost to those being served – are in addition to the free and subsidized healthcare that hospitals give to those who cannot afford it. Community benefit programs are not reimbursed by state or federal governments, by any health insurance company, or through any public subsidy. These programs have continued through the duration of the pandemic, and include efforts aimed at food security, housing stability, public health education, and expanding equitable access to care, among other initiatives.

According to the Massachusetts Attorney General’s Office, in FY2020, 57 non-profit acute care hospitals in Massachusetts reported a total of $786 million in community benefit expenditures.

The IRS, allowing hospitals to count financial losses related to care provided to Medicaid recipients, along with medical education costs and other metrics, totals Massachusetts hospital community benefits at more than $3.15 billion.

Hospitals Explore Affiliations, Expansions

Heywood Healthcare and UMass Memorial Health have signed a non-binding letter of intent that allows them to explore an affiliation. According to a media release from the hospitals, if the proposed deal goes through – and both sides expect it will take a year to explore – Heywood would become a member hospital within the UMass Memorial Health system, joining UMass Memorial Medical Center, UMass Memorial Health – Harrington Hospital, UMass Memorial Health – HealthAlliance-Clinton Hospital, and UMass Memorial Health – Marlborough Hospital.

Heywood says that while negotiations continue there will be no disruption if its services. All sites remain open and patients will continue to use Heywood campus locations and physician offices for routine appointments, emergency care, and diagnostic testing, including imaging, labs, cancer care, inpatient admissions, surgical procedures, and behavioral health.

Mass General Brigham (MGB) last Wednesday received approval from the state’s Public Health Council to proceed with a $158 million expansion of Brigham and Women’s Faulkner Hospital, consisting of a five-story addition to the hospital containing 78 medical/surgery beds, an 8-bed observation unit, and an MRI unit, among other expansions.

MGB also won council approval for its $1.9 billion project to expand Massachusetts General Hospital by constructing two connected towers at its main campus. The project involves the creation of private beds, relocation of oncology services, expansion of cardiac services, and construction of new operating rooms, among other expansions.

Using Telehealth to Make Paxlovid Widely Available

The push to make Paxlovid widely available to Massachusetts residents continues. Last week the Baker Administration announced a new telehealth line that any COVID-positive patient with mild-to-moderate symptoms can call to see if they are eligible for the Paxlovid pill that has proven to be 90% effective in reducing severe symptoms and hospitalizations.

Clinicians are available every day from 8 a.m. to 10 p.m., and the telehealth consult is free. Insurance is not required. Individuals 18 and over will have to show ID (which will not be shared), a photo or PDF of their positive COVID test result; a list of medications and vitamins they are taking; and, if they have kidney disease, a copy of their lab results from the last three months. People can use any smartphone or computer that has video.

For more information, including how to access the service, click here.

What if Roe v. Wade Were Overturned?

The leaked, draft Supreme Court Decision on the challenge to Roe v. Wade generated an immediate reaction in Massachusetts where the legislature in December 2020 passed The ROE Act, which enshrines in state law abortion rights.

Last week, Governor Baker, who supports the right to access reproductive healthcare but objected to the ROE Act’s allowance of those under 18 to get an abortion without parental consent, criticized the leaked SCOTUS ruling’s apparent overturning of Roe v. Wade. He told the State House News Service that he would consider a state law to provide legal liability protection to Massachusetts providers offering abortion services to patients from other states where abortion may become illegal.

Saying he did not want to get too ahead of the issue, Baker added, “But I am absolutely open to discussing protections if we need to pursue some because obviously I and others here are very concerned about what this means, not so much for people in Massachusetts but for people in other states, so I’m up for that conversation.”

Department of Public Health Commissioner Margret Cooke said of the leaked opinion, “Reproductive health services in Massachusetts remain protected, intact, and uninterrupted. As the Governor and [EOHHS] Secretary [Marylou] Sudders stated yesterday, while an overturn of Roe would be a massive setback in states without laws protecting abortion access and reproductive health services, this Administration, and this Department, are proud to support the right to choose, and Massachusetts will always protect that right.”

MHA’s President & CEO Steve Walsh said, “We are proud of the commonwealth’s long history as a leader in reproductive rights. Along with our elected officials, we are committed to maintaining the strong infrastructure our healthcare providers have built for individuals seeking safe, accessible reproductive care.”

Disruptions to CT Scan Screenings

Massachusetts hospitals, and hospitals nationally, are reporting critical shortages of the contrasts used in CT scans and other imaging. The nationwide shortage is due to manufacturing and production issues in China. Radiologists throughout the hospital community are assessing how to prioritize scans, reschedule imaging, or perform some scans without contrast.

John LoDico, Editor