INSIDE THE ISSUE

> National Recognition on Equity
> The Steward Saga
> FOCUS ON WORKFORCE: BMC’s Mental Health Specialists
> Markey on Broadband Access

MONDAY REPORT

Mass. Hospitals Achieve First-in-the-Nation Health Equity Distinction

MHA and The Joint Commission today announced that Massachusetts is the first U.S. state in which all hospitals have taken the meaningful step to close health disparities by meeting The Joint Commission’s (TJC’s) new healthcare equity accreditation standard. To further the state’s commitment to health equity, these hospitals plan to achieve The Joint Commission’s Health Care Equity Certification by 2025.

In 2023, The Joint Commission introduced a new accreditation standard with six requirements for hospitals across the nation to meet – demonstrating that reducing health disparities is a quality and safety priority. Over the past year, Massachusetts acute care hospitals were evaluated for adherence to these comprehensive healthcare equity accreditation requirements, and every hospital was determined to operate in accordance with them. The independent, non-profit TJC accredits and certifies more than 22,000 healthcare organizations and programs in the United States.

“This recognition is a testament to our healthcare community’s commitment to set a national standard when it comes to what accessible, culturally competent patient care looks like,” said Izzy Lopes, vice president of health equity at MHA. “We applaud our hospitals and caregivers for their tireless work to meaningfully anchor health equity into everything they do. And we are especially grateful for the Executive Office of Health & Human Services’ leadership and collaboration in shaping the historic 1115 Medicaid Waiver that made this accomplishment possible.”

Massachusetts hospitals are now working towards obtaining the advanced TJC Health Care Equity Certification, which emphasizes the structures and processes healthcare organizations need to implement to decrease health disparities in their patient populations; promote diversity, equity, and inclusion for their staff; and address five key domains: leadership, collaboration, data collection, provision of care, and performance improvement.

To learn more, visit The Joint Commission’s Health Care Equity Accreditation Resource Center. Learn more about MHA and its partners’ commitment to health equity here.

Healey to Steward: Figure Out a Way to Get Out of the State

The Steward Health Care saga is continuing to roil the Massachusetts medical sector. Last Tuesday, Governor Maura Healey sent Steward’s CEO Dr. Ralph de la Torre a very pointed letter saying that Steward’s ongoing failure to provide required financial data to the state is “an affront to the patients, workers, and communities that the Steward hospitals serve.”

“The time has come to move past our many months of discussions and begin executing a safe, orderly transition of your seven licensed facilities in Massachusetts to new operators as soon as possible,” Healey wrote.

On Friday, Steward’s Michael Callum, M.D., responded, disagreeing with the governor’s criticisms, but agreeing that it is best for Steward to leave the Massachusetts market. “We would welcome the opportunity to meet with you personally concerning the orderly departure of Steward from Massachusetts,” Callum wrote.

Also last week, U.S. Rep. Steven Lynch (D-Mass.) held a press conference in front of the Steward’s under-construction Norwood Hospital to announce that contractors have stopped work on the project because they have not been paid. “Right now we’re stuck with a hospital that’s not built,” the Boston Globe quoted Lynch as saying.

On February 21, Medical Properties Trust (MPT) – the entity that owns the property on which Stewards’ Massachusetts hospitals sit, and which charges rent to the facilities – issued a press release on its fourth quarter results. Although Steward is in arrears on those rents, MPT said that the trust along with other “asset backed lenders” is providing Steward with bridge funding. MPT’s Chairman, President, and CEO Edward Aldag, Jr., also said, “With regard to Steward, we are encouraged by the amount of interest received to date from other hospital operators for these mission-critical facilities, and we expect this real estate portfolio will either resume its contributions to earnings or become additional sources of liquidity as the year progresses.”

Among the questions any new operator of Stewards’ existing hospitals in the commonwealth must ask are: Does it make sense to run the hospital but not own the facility, requiring us to pay rent to MPT? What’s the condition of the hospitals’ physical plant if we buy them, and what will it cost to improve them? And do we have the workforce and resources to keep the hospital afloat financially?

Governor Healey has recognized the financial challenges that high public-payer hospitals face, but in a recent interview with the Globe she said that Steward’s reimbursement excuse for its financial problems was “laughable.”

“I think you should contrast what’s playing out at Steward versus what’s happening in other hospital systems that are challenged,” Healey said. “What you don’t see in those settings is an individual and a company that’s come in and essentially looked to strip as much of the asset as it can, to line their own pockets.”

For MHA and its members, the Steward question has obviously been of the utmost importance. The Steward Health Care system has not been part of MHA, nor most of its initiatives, since January 2012 when its leadership announced it was leaving the association.

“While the Massachusetts healthcare system is already navigating a capacity and workforce crisis on a daily basis, its hospitals care deeply about patients’ access to equitable care and the livelihood of caregivers everywhere,” said MHA President & CEO Steve Walsh. “Our MHA community of 60-plus hospitals is here to be a part of the solution, starting with a firm understanding of any Steward services that may be affected in the future and the exact capabilities of other providers to bridge the gap. We hope to soon have a more concrete outlook on Steward’s operations and the role MHA members can play in the response. If this is indeed our next public health crisis, it will take everyone – hospitals, state leaders, insurers, organized labor, and beyond – working in lockstep to minimize the effect on patients and their dedicated care teams.”

FOCUS ON WORKFORCE

BMC Trains Next Generation of Mental Health Specialists

These critical positions – also known as Behavioral Health Techs – engage directly with patients throughout the day, serving as the main point of contact and also as the eyes and ears of the medical team to whom they report back their observations on patients.

In the latest addition to MHA’s Workforce Toolkit, Tracey Weeden, executive director of BMC’s Brockton Behavioral Health Hospital, discusses how the program came about, and how it functions. Those recruited for the program receive 10 weeks of college courses, followed by on-site preceptorships, ultimately leading to Mental Health Specialist certificate – the first in the commonwealth – and employment on a unit.

“Brockton Behavioral Health Center has had six participants go through our program and we’ve actually hired four of the participants – two are full time and two are per diem, and one of the per diems decided to go back to school to continue their education while they’re in the program,” which is encouraged, Weeden says.

“We’re actually pretty intentional about engaging individuals who are, number one, from our community or surrounding communities, and who identify as people of color,” she says. “We see this a lot: people who move to the United States and were doctors, nurses, teachers their country of birth and then move here and either because they can’t afford to or they are taking care of their families or are trying to acclimate to a new community – but they haven’t been able to go back to school or get their Board Registration and license.”

Weeden says by intentionally engaging such individuals – who also happen to reflect the communities being served – the program allows people to “get their foot in the door” of a large healthcare system, which is a win for the worker, for behavioral health patients, and for BMC.

Learn about other workforce initiatives throughout the state by visiting MHA’s Workforce Toolkit. Do you have a workforce program that you would like featured in the toolkit? Contact MHA’s Kim Stevenson at kstevenson@mhalink.org.

Markey Pushes for Greater Broadband Access to Support Digital Equity

Senator Edward Markey (D-Mass.) continued his push last week to extend funding for the Affordable Connectivity Program (ACP), which is set to expire in April. The $14.2 billion program was created and funded through the Bipartisan Infrastructure Law in 2021 and lowers the out-of-pocket cost of broadband service and devices for eligible households, including 366,000 in Massachusetts, according to Markey. The Biden Administration has endorsed $6 billion in supplemental funding for the ACP.

“The end of the Affordable Connectivity Program would be a lose-lose-lose — a loss for families, a loss for our economy, and a loss for our democracy,” Markey said at an event in Lynn last Tuesday. “We must treat internet access like a public good and ensure that everyone is connected online. It is absolutely vital that Congress provide additional funding to the ACP and close the digital divide once and for all.”

Assisting internet connectivity to households is not only a social equity issue, but is supported by educators, who cite the increasing role of learning through the internet, and especially by healthcare providers, who note the dramatic increase in telemedicine encounters that began during the pandemic and that continue unabated.

“Funding the ACP is not just an internet access issue – it’s a healthcare issue,” said Mass General Brigham ER physician, Link Health Founder, and Harvard Assistant Professor Dr. Alister Martin. “Modern healthcare is intrinsically linked to internet access. The Affordable Connectivity Program fosters health equity and access among those who need it most.”

MHA’s Senior Director of Virtual Care & Clinical Affairs Adam Delmolino, who attended the Lynn event last Tuesday, said, “Affordable, reliable high-speed internet is critical to healthcare, education, and work and just for everyday activities. Still, too many are being left behind without these necessities because they are inhibited by excessive costs. In particular, these inequities affect underserved communities, rural communities, veterans, and older Americans where the lack of affordable, reliable internet contributes to significant economic, education, and health disparities. MHA and the Massachusetts Telemedicine Coalition strongly support Senator Markey’s efforts to fund the ACP to assist with mitigating the digital divide for patients.”

John LoDico, Editor