Posted by Steve Walsh on Dec 21st, 2020 11:40pm

2020 wasn't the year any of us would have expected. But we are stronger for it, we are more united because of it, and our commitment to our patients has never been deeper. Here's what we'll remember.

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Posted by Steve Walsh on Nov 13th, 2020 2:29pm


Hundreds of female healthcare leaders from across Massachusetts gathered virtually to attend MHA’s Annual Women Leaders in Healthcare Conference, Leadership Redefined. The program featured interactive presentations on communication and negotiation skills, fostering inclusion and equity in the healthcare setting, building executive leadership, mentoring and more. Wellbeing for both leaders and their teams was the prevailing theme throughout the day.

Marylou Sudders, Massachusetts’ Secretary of Health and Human Services, delivered a video greeting to kick off the event. She thanked MHA and its leadership “for ensuring a strong, unified voice for our hospital and healthcare community in Massachusetts.”

Secretary Sudders also praised the current and aspiring women healthcare leaders in the commonwealth for their dedication and resilience and urged the conference attendees to tackle current challenges head-on, while still remembering to take care of themselves.

“During this extraordinary and challenging time – a pandemic, increasingly rancorous political divides, and an inflection point, confronting structural racism in our country once and for all – we must find our strength, and to do so with resolve,” Sudders said. “And to do so, ladies out there, you must also take care of yourself…It is a sign of strength to seek assistance, it is not a sign of weakness.”

The Women Leaders in Healthcare conference was emceed by Ceclia Houser, founder and president of C-Change: Executive Coaching Exemplified, who offered her own insights while overseeing the sessions and sharing questions from the audience.

“One way we’re reimagining healthcare is to acknowledge the life-changing work of our healthcare leaders, who have adapted at breakneck speed,” Houser said, adding that the first speaker of day, LaShyra “Lash” Nolen, Harvard Medical School’s first Black woman class president, personified “what leadership looks like in the new normal.”

Nolen, who began her remarks with moments of dedication to Breonna Taylor and Dawn Wooten, spoke about her personal inspirations and her journey to becoming the first Black woman elected class president of Harvard Medical School, as well as her advocacy for humane and equitable healthcare reform.

“[My grandmother] spoke life, breath and love into my dreams… and my mother was also the first person in my family to get both her bachelor’s and her master’s degree,” Nolen said. “So they are my why, they are my reason, and they are the force behind everything that I do.”

She said her experiences growing up and her two gap years – providing diabetes education in Spain on a Fulbright program, and serving with the AmeriCorps National Health Corps-Chicago – gave her unique inspiration to advocate to address health disparities as she entered medical school.

Nolen also recounted a special moment when Vice President-elect Kamala Harris gave her a shout-out on Twitter shortly after Nolen was elected the first Black woman class president of Harvard Medical School last year.

“I think that both of our messages have really been the same: It’s not about being the first, but ensuring that you’re not the last,” she said.

Suzanne Bates, CEO of Bates Communications, led attendees through a workshop on negotiation tactics and how to gain self-confidence by focusing on what she described as women’s strong problem-solving skills.

“Confidence is pretty much gender-neutral in how men and women are viewed,” said Bates. “But women are rated higher in terms of being willing to take on difficult issues without delay.”

Emerson Hospital President & CEO Christine Schuster, RN, MBA, then led a wide-ranging panel discussion on resilience and self-care lessons learned during the COVID-19 pandemic with three senior female hospital leaders: Nancy Gaden, DNP, RN, senior vice president and CNO of Boston Medical Center; Cheryl Lapriore, chief of staff, UMass Memorial Health Care; and Deborah Bergholm-Petka, MS, director of organizational development, Circle Health/Lowell General Hospital.

The panelists discussed the strategies they’ve used to take care of themselves and their team members during this stressful and exhausting time. Tips included having honest and authentic conversations with staff, expressing gratitude, and setting a great example in modeling both good self-care and caring for others. They also agreed that humor is a key element of instilling wellbeing within their teams, and shared some examples of how they’ve managed to lighten the mood under strenuous circumstances.

MHA shared the voices of several other women leaders in a video. The women were asked to describe what “Leadership Reimagined” meant to them.



Hiyam Nadel, MBA, RN, BSN, nursing director in the Department of Obstetrics and Gynecology and director of the Center for Innovations in Care Delivery, Massachusetts General Hospital, shared a presentation on healthcare innovation geared to nurses, the largest sector of the healthcare workforce. She describes innovation as “methodological approaches infused with creativity and risk-taking,” and recommended using real people (especially frontline workers) and situations to design new programs or prototypes.

Massachusetts Women’s Forum President Jackie-Jenkins Scott then moderated a fireside chat on mentorship with Sandra L. Fenwick, CEO of Boston Children's Hospital and Patrice A. Harris, MD, MA, immediate past-president of the American Medical Association. Both Fenwick and Harris noted their deep concern about the loss of a large percentage of women in the U.S. workforce in the wake of the pandemic.

“Economic issues, the lack of quality affordable options for our children, the fact that a big group of us are truly members of a sandwich generation…what we are trying to do as women is becoming more and more challenged,” said Fenwick.

“We need to transform ‘normal’ to support choices [for women in healthcare],” said Harris.

Both women urged attendees to broaden their concept of mentorship and sponsors.

“Mentoring and sponsorship take many, many forms,” Fenwick said.

The event concluded with Hannah Ubl, co-founder of Good Company Consulting and communication and culture expert, who discussed how “reimagining healthcare” requires transformational change, and what that means for today’s workforce.

“For transformational change, we need to seek discomfort over comfort,” Ubl said.

But while most people equate discomfort with pain, and instead seek comfort through distraction or sameness, today’s changing workforce landscape means healthcare leaders need to expand their comfort zone and equate discomfort with growth. This means being honest about what you fear, what changes you might be resisting, and figuring out why you are resisting. Then, Ubl said, leaders should embrace the idea of calm and model what ‘calm’ looks like.

Ubl also touched on the importance of wellbeing, particularly in terms of good self-care, for leaders.

Ubl left attendees with a quote from Arundhati Roy that is apropos of both the conference’s themes and the times we are living in:

“Another world is not only possible, she is on her way. On a quiet day, I can hear her breathing.”

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Posted by Steve Walsh on Oct 27th, 2020 11:09am

The Health Policy Commission held its annual Cost Trends Hearing last week, with a focus on health equity and the effect of COVID-19 on the commonwealth’s healthcare system. From the remarks by state leaders that bookended the event, to a deeply personal video presentation on the Massachusetts surge experience and several conversations around inequity, the event was a fitting reflection of the unprecedented challenges facing both our healthcare community and our society.

At the hearing’s outset, Governor Charlie Baker and Secretary of Health and Human Services Marylou Sudders spoke about the work of hospitals and healthcare providers as they continue to step up and stand strong in the face of this deadly, insidious public health crisis. 

“Healthcare workers are perhaps our greatest asset in fighting this virus,” said Governor Baker in his video message to attendees, adding that the capability and fortitude of the healthcare workforce is what has allowed the system to remain nimble throughout the year.

“While we were stretched and strained…you saw the collaboration of our healthcare community. It acted and performed as a system,” Secretary Sudders said as she recounted the efforts providers undertook during the initial COVID-19 surge.

Both the Governor and the Secretary emphasized that the lessons learned during the pandemic – such as the power of telemedicine – must be acknowledged for their long-term value, even after the virus has been eradicated.

The original video that HPC staff shared highlighted the effect of COVID-19 from a variety of residents’ perspectives, including patients, business owners, healthcare leaders, and caregivers. Several MHA members provided moving and inspiring accounts of the challenges and innovative approaches they undertook to navigate the first surge of cases here. 

“I think we emerged from this with a very different relationship with our community,” said UMass Memorial Health Care President & CEO Dr. Eric Dickson, who was featured in the piece.

The keynote address and discussion panels focused largely on health equity and what organizations are doing to address the needs of underserved populations. Healthcare leaders including Dr. Thea James, Vice President of Mission and Associate Chief Medical Officer at Boston Medical Center, and Deborah Wilson, president & CEO of Lawrence General Hospital, explained that they were “looking inward” at policies and practices that can improve how they reach patients, employees, and community members. The leaders cited local partnerships, the careful structuring of care models, and access to behavioral health and telehealth services as key in fostering a more equitable system. 

Panelists also lauded the role that telehealth has played during the pandemic, emphasizing its ability to increase access to care even after COVID-19 has been defeated. Dr. Steven Strongwater, president & CEO of Atrius Health, articulated the essential need for widespread telehealth coverage and indicated that increased co-pays for virtual services could magnify health inequities.

A second panel of experts spoke about some of the work that they’ve seen as key within the healthcare system during the pandemic, as well as what we should be paying attention to moving into the winter. Dr. Thomas Sequist, Chief Patient Experience and Equity Officer for Mass General Brigham, briefed the commission on his organization’s “COVID equity response,” which included expanded testing, partnering with local community health centers, and accommodating language barriers when communicating important information. 

Dr. Shari Nethersole, Executive Director for Community Health at Boston Children’s Hospital, recounted how the hospital took in pediatric patients from nearby facilities as the first wave struck and the central role that telehealth played for behavioral and primary care. Dr. Nethersole remarked that behavioral health will be a major point of focus as the crisis continues.

Attorney General Maura Healey in a video message played at the end of the hearing joined other state leaders in expressing gratitude to the healthcare community and frontline workers.

“You have helped us through a difficult first phase of this pandemic, shouldering extra burdens and risks, and we are grateful to you,” she said. Healey also discussed the longstanding health disparities in Massachusetts and nationally that the COVID-19 pandemic has only exacerbated. 

“We must be willing to change longstanding systems that disenfranchise marginalized communities,” Healey said. “We must also recognize that the healthcare system alone cannot end health disparities, which are rooted in a broad range of deep-seated inequities.”

This year’s Cost Trends Hearing was an important opportunity to reflect upon the tireless work of our providers as they battle the COVID-19 pandemic and continue to address the longstanding health inequities that are all too prevalent in our communities. MHA is proud to work with our hospital and health system members, in partnership with state government, as we confront the next chapter of this public health crisis and improve the lives of all residents.

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Posted by Steve Walsh on Sep 25th, 2020 10:46am


Familiar faces. Timely topics. Unprecedented times.

Hundreds of healthcare leaders from across New England tuned into MHA’s Annual Leadership Forum, Healthcare Reimagined. The full-morning online session was broadcast live and featured nationally renowned healthcare thought leaders, health equity and inclusion experts, and a COVID-19 survivor who took us behind the mask of the patient experience. 

The event featured many of the commonwealth’s leading healthcare voices, with opening remarks from Jody White, MHA Board Chair and Lowell General Hospital and Circle Health President & CEO, as well as a video montage of the many ways to reimagine healthcare from members of MHA’s Executive Committee. Governor Charlie Baker also addressed attendees via video message, acknowledging how the healthcare system has stepped up and never closed its doors throughout the pandemic.



"What does it mean to be an American and have healthcare?"

As PBS’ NewsHour White House Correspondent, Yamiche Alcindor has had a front-row seat to the frantic activity on Capitol Hill, all of which is central to the future of healthcare. She provided attendees with a sharp, well-informed picture of the 2020 election and the state of the American public. Alcindor argued that healthcare will be one of the pivotal issues leading into November, specifically noting candidates’ differing views on the prospect of a COVID-19 vaccine. 

Dr. Atul Gawande, MD, MPH, founder and Chair of Ariadne Labs and Cynthia and John F. Fish Distinguished Chair in Surgery at Brigham and Women’s Hospital, discussed in his keynote address how Massachusetts’ healthcare and scientific communities are making outsize contributions to confronting and ultimately defeating COVID-19. Gawande, one of the nation’s most sought-after healthcare thinkers and speakers, stated, "We didn't just do it here in Massachusetts, we showed the rest of the country how it should be done.”

Gawande also highlighted how the Stockdale Paradox is particularly apt when envisioning defeat of COVID-19: it requires both faith in ultimately prevailing, and strong discipline to face harsh realities about what sacrifices that success might require. Given our success in managing the crisis during the first wave, he explained that providers must continue to focus on bolstering primary care, strengthening telehealth, and facing the racial and educational factors that affect health.



Physician and health reporter Mallika Marshall, M.D.; served as emcee of the forum, as well as moderator for a panel discussion on Health Equity and the Urgency of Now. Panelists Thea James, M.D., from Boston Medical Center; Frank Robinson, PhD, from Baystate Health; and Carl Sciortino from Fenway Health tackled pressing questions about systemic racism in healthcare and health disparities. They held an open conversation about what their organizations were doing to prioritize diversity, equity and inclusion. When asked what others in the healthcare space should prioritize, the panel keyed in on the creation of policies that deliberately provide pathways to traditionally marginalized individuals and the use of data to highlight the intersection between race and health outcomes.

Of course, no conversation on healthcare is complete without the voice of the patients. Frank Cutitta, who spent over 100 days in the COVID ICU, chronicled his remarkable story of struggle and recovery. Frank was in a coma for 40 days after contracting the virus and his family faced unthinkable decisions. His harrowing experience did have moments of relief, like when nurses would play Pavarotti and the Beach Boys, or would set up video chats between him and his family. Frank emphasized the importance of the human connection in treating isolated patients, who may feel an acute sense of loneliness while hospitalized.

In program’s the closing moments, MHA president & CEO Steve Walsh reminded attendees that the time for innovative action is now. 

“Healthcare reimagined isn’t about predicting the future. It’s about creating the future.” Walsh said.

A pair of quotes from Abraham Lincoln bookended the day, serving as calls to advance: 

“Commitment is what transforms a promise into reality. It is the words that speak boldly of your intentions. And the actions which speak louder than words.” 

“The best way to predict the future is to create it.” 

Check out upcoming MHA Education events here.


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Posted by Steve Walsh on Sep 8th, 2020 2:57pm

The following blog post is from Guest Commentators Lou Woolf, President & CEO, Hebrew SeniorLife and Robin Hynds, MSN, RN, CPHM, Senior Vice President, Network & Strategic Operations, Chief Clinical Integration Officer, Lawrence General Hospital.



For many patients, being discharged from the hospital doesn’t mean returning home or back to life as usual. That’s why we have providers that deliver care in “post-acute” settings, such as long-term acute care hospitals, inpatient rehabilitation facilities, assisted living residences, skilled nursing facilities, hospice, and home care.

Our post-acute providers have always played an invaluable role in our healthcare system, but their work has been especially crucial to Massachusetts’ COVID-19 response. It’s an effort that has required quick action, close collaboration, and heroic work from caregivers.

Addressing the Challenge Together 

As the initial COVID-19 surge approached here in Massachusetts, sustaining acute care hospital bed capacity was among the most urgent priorities for the healthcare system. Transitioning recovering patients to non-acute settings, once they were healthy enough to do so, was a necessary way of keeping hospital beds open for the sickest patients.

But with so many moving pieces within the system and a rapidly growing number of COVID-19 patients no longer in need of acute care, what were the most efficient ways to transition these recovering patients to post-acute facilities? And what were some of the safety standards that organizations should adopt for the protection of these patients, non-COVID-19 patients, and staff? These were unique problems that required speedy, collaborative solutions.

We brought together a Post-Acute Care Transitions Workgroup in late March, which included nearly 50 members representing every segment along the continuum of care and across the commonwealth. With support from the Massachusetts Health and Hospital Association (MHA), we met virtually every week to discuss our greatest challenges, needs, ideas, and solutions on how to streamline the way patients are transferred and admitted to post-acute settings after leaving the hospital.

This workgroup of hospitals and post-acute providers accomplished a great deal in a short amount of time. We developed recommendations on the transition process for assisted living, inpatient rehab, and long-term acute facilities - recommendations that are now in process of being applied across the state. We focused on safety recommendations, such as patient testing criteria and infection control in skilled nursing facilities and the use of personal protective equipment (PPE) coaches to ensure the effective and efficient use of PPE in post-acute settings. We also raised awareness of the importance of advance care planning conversations in all types of care settings during this pandemic.

At the heart of all this work is our shared mission to provide patients with the right care, in the right place, at the right time. This was a priority before COVID-19 arrived, but it became an absolute necessity once the pandemic, and its potential to overwhelm our healthcare system, required us to develop new ways to serve our communities most effectively.

We are thankful that many of these recommendations have been embraced by our partners at the state and are already making a difference in the way we deliver care and interact with one another during this unprecedented public health crisis. When we are coordinated and actively listening to those from other parts of the healthcare system, it’s our patients who benefit most.


The Heroics of our Caregivers

Planning means nothing without execution. Throughout this crisis, post-acute caregivers have done absolutely heroic work in making sure every patient in need of care – whether for COVID-19 or not – is treated in an effective, safe, and timely manner.

These healthcare professionals face the unknown on a daily basis, for both themselves and their families. Home care workers enter patient homes where the ability to mitigate their exposure to COVID-19 is much less within their control. Those working in assisted living, long-term acute care, and skilled nursing facilities feel the pressures of treating large volumes of at-risk individuals. And yet, they continue to show up, make their patients comfortable, and provide world-class care.

We owe these unsung heroes a huge debt of gratitude. We are fortunate that we can rely on their fortitude and commitment at a time when seemingly everything else is uncertain.  

The Path Forward

Our workgroup provided a voice and representation for those across the healthcare continuum. It’s critical that we continue to provide a platform for those voices in the long term.

With that aim in mind, the workgroup will become a subcommittee of the existing MHA council chaired by the two of us - the Continuum of Care Council (CCC). The CCC, comprised of representatives from hospitals and post-acute organizations, will keep its finger on the pulse of the issues and needs of the post-acute community, and will establish actionable solutions to improve our synergy with hospitals and the care we provide, thus improving care across the continuum. Many of the obstacles highlighted by the COVID-19 pandemic existed long before this crisis began, and we look forward to addressing those in collaboration with colleagues across the state.

Of course, this public health crisis is far from over. With a second wave anticipated this fall, our coordination will be more valuable than ever. We are proud to have created an infrastructure for the hospital and post-acute community to come together and confront any challenges this virus presents us in the months ahead.


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Posted by Steve Walsh on Dec 9th, 2019 10:58am

By Maryanne C. Bombaugh, MD,  and Steve Walsh

 (The following was published in the Boston Globe opinion section on Dec. 9, 2019)

Understanding and navigating the health care system is more challenging for patients than at any time in history. The complexities and variations among insurance plans on issues of coverage, out-of-pocket costs, and payment for care are extraordinary as compared to other consumer services. One of the most pressing examples is "surprise medical billing." Such instances occur when a patient receives medical services and is unknowingly cared for by a clinician from outside of the patient’s insurance network. The predictable and understandable result is stress, anger, confusion, and despair.

Local and national policymakers are correctly focusing attention on this issue. When surprise billing occurs, patients are unfairly put in the middle of a matter that should be resolved by their health plan and provider. Corrective actions are long overdue.

Hospitals and physicians are united in their belief that patients should never receive a surprise bill and should be responsible only for what they would customarily pay for in-network care as specified by their insurance policy. In an effort to force change on behalf of our patients, the Massachusetts Medical Society and the Massachusetts Health & Hospital Association are supporting legislative efforts aimed at holding patients harmless, requiring transparency, demanding network adequacy, and insisting that information on care and coverage is easily accessible and easy to understand.

The right solution should be modeled on a 2015 law adopted in New York. It has proven effective in protecting patients from surprise medical bills and has rightly taken them out of the middle of negotiations between health care providers and insurance companies. The law does so by holding patients harmless, and then encouraging providers and insurers to negotiate a rate when unexpected out of network care happens. And, if that fails, by establishing an arbitration model that compels providers and insurers to reach resolution through an independent arbiter.

The New York model relies on "baseball-style" arbitration. If the provider and insurer cannot reach resolution on a payment amount, each side brings their "last, best offer" to the table. The arbiter picks one of the two offers and there is no middle ground. By eliminating the option of modification, it is incumbent upon each side to bring forward realistic, reasonable proposals.

In 2017, seven million people were treated in New York hospital emergency departments, and of those cases only 849 went to arbitration. The average cost of arbitration was $225 to $325 per case, paid by the losing side. Arbitration decisions have been pretty evenly split between providers and insurers, and all involved — patients, health care providers, insurers — support the law as a reasonable solution to a complex problem. The effect of the law on costs has been positive as well, with the growth of health care premiums in New York being significantly less than the national average.

Despite the demonstrable success of the New York model, the insurance industry in Massachusetts is pushing for government-mandated "benchmarking" to determine rates paid to physicians. In other words, while the root cause of surprise billing is inadequate insurance networks, the insurers’ answer to this pressing problem is government rate-setting with no direct benefit to patients.

Benchmarking is inherently biased and would force clinicians to accept specific, mandated rates based on often inaccurate data supplied by the insurance companies themselves. Most troubling, it would undermine patient access to care — especially in smaller communities where hospitals are struggling and access to physicians is limited. The heavy hand of government would create an unfair imbalance in the health care marketplace and insurers would have no incentive to engage physicians in building robust health care networks. The connected system of care we have all been working towards in Massachusetts would immediately become fragmented and disjointed. How do we know? It’s happening right now in California following the recent enactment of a rate-setting approach to surprise billing.

The surprise billing issue is understandably one of great concern for our patients. We must immediately implement a solution that expands patient protections. At the same time, we must also preserve and advance patient access to health care services. The New York approach is a proven method to protect patients from surprise medical bills while ensuring their continued access to physicians and other committed caregivers. Massachusetts should follow its lead.

Dr. Maryanne C. Bombaugh, MD,  is a practicing obstetrician/gynecologist and president of the Massachusetts Medical Society. Steve Walsh is president and CEO of the Massachusetts Health & Hospital Association.


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Posted by Steve Walsh on Jul 29th, 2019 11:40am

The following blog post is from Guest Commentator Jody White, President and CEO of Lowell General Hospital and Circle Health, Executive Vice President of Wellforce, and the current chair of the MHA Board of Trustees:

As I assume the Chair of the Massachusetts Health and Hospital Association Board of Trustees, healthcare in our state and nation finds itself on the precipice of transition and change.

In Massachusetts, we are privileged to have access to some of the greatest talent in the country, if not the world, and with that privilege comes a responsibility to light the way forward.

It is my hope that over the next year I can help our member organizations advance our goals by driving consensus in three areas that will shape the future of care.

First, we must continue to expand our thinking well beyond the four walls of the hospital as we seek to better connect all components of our commonwealth’s health system. And it is crucial that these efforts be driven and informed by the voices of our physicians. Our caregivers drive innovation at their own workplaces every day and their voices will prove to be an invaluable part in evolving our system as a whole.  

Second, we must understand our association’s role in moving care “upstream” and address those factors that challenge health. What is our role in advancing the agenda to address social determinants of health? And are we prepared to challenge a fee-for-service delivery system that needs disruption?

And finally, we need to keep our great association focused on working together as a powerful voice that is prepared to move healthcare forward.

As our industry continues the march towards value and reducing the total cost of care, it will be critical that we find innovative ways to connect all aspects of healthcare delivery; continuing to work in disconnected silos will only serve to hinder our progress.

These forces will drive us to a better understanding of the complete care continuum, to new and expanded partnerships that improve access and efficiency, and of course the imperative to engage and empower our physicians as never before.

It’s very important work.

When we added "Health" to the MHA name, we did so with purpose.  Collectively we all have numerous and varied efforts underway to bring our community benefit plans to life, and to fulfill our responsibility to improve the health and wellbeing of the communities we serve.

As I think about our industry evolving away from traditional, fee-for-service transactions and towards a renewed focus on creating health, I believe the MHA member organizations are poised to add value.

At Lowell General Hospital and Circle Health, we are taking bold steps to improve the overall health of our communities by improving access to care and proactively addressing the non-clinical factors that lead to high utilization, readmissions and poor outcomes.

By looking to have a more "upstream" influence on the well-known factors that affect the health of those we serve, we are challenged to move away from our fee-for-service system that rewards "doing things to sick people."

We will be asked to think differently about not only the total cost of high quality care but also about finding new ways to fund investments that prevent illness in the first place. Several of our members are well along in this journey and it is my hope we can all learn and engage.

Additionally, all of this work would benefit from enhanced partnerships with the payer community.  Finding common ground and fixing our eyes on strategic partnerships that focus on protecting and improving health versus transacted, multi-year contracts will be essential.

Over the next year, I look forward to leveraging our collective knowledge and strength to advance an agenda that is impactful, transformative and helpful to all whom we serve.


Jody White is President and CEO of Lowell General Hospital and Circle Health, Executive Vice President of Wellforce, and the current chair of the MHA Board of Trustees.


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Posted by Steve Walsh on Apr 18th, 2019 9:56am

By MHA President & CEO Steve Walsh

As the Massachusetts Health & Hospital Association (MHA) and its member hospitals and healthcare systems continue to work with policymakers to improve affordability and enhance high-quality patient care, we strongly support the tenets of universal healthcare coverage and maintaining a robust system of patient access. However, we are opposed to "Medicare for All," as it could endanger the collective success we have achieved in Massachusetts and inhibit access and harm healthcare quality across the country.

The Commonwealth serves as a paragon of healthcare reform and universal access. The combination of our statewide policies and the implementation of the Affordable Care Act (ACA) have helped to secure health insurance coverage for 97 percent of Massachusetts residents – the highest rate in the nation. At the same time, our costs are growing more slowly than the national average and we are consistently beating ambitious cost containment benchmarks while offering some of the highest levels of quality patient care in the United States. Coverage expansion has allowed us to direct our focus on equitable access, population health management, and other targeted investments in social determinants of health that lead to improved quality of life and better outcomes.

MHA urges policymakers to prioritize preserving and expanding the gains that have been made nationally through the ACA. Despite delivering promising results in many states, not every area of the country has been able to take advantage of the opportunities offered by this comprehensive package of policies. Even more disturbing, efforts to dismantle the ACA continue through funding cutbacks coupled with ongoing legal and regulatory challenges. Proposals such as "Medicare for All" carry significant risk for our complex system of patients, healthcare providers, and taxpayers. We should instead focus our attention on stabilizing the ACA.

Medicare is an essential program for seniors and disabled Americans. It is successful because we all depend on it – every elder American is eligible, regardless of their financial and health status. Because of its importance, its support remains a national priority. The long term effect of Medicare expansion comes with the risk of an underfunded program, resulting in a two-tiered system of care – middle-class and low-income elders would struggle with limited coverage, while wealthy Americans could supplement the available benefit. We fear that the many proposals grouped under the "Medicare for All" banner put the viability of the program – which is already strained – directly at risk. These proposals could also endanger providers' ability to continue offering services, thereby endangering patients' access to care.

Without doubt, more work needs to be done to improve care delivery, to close the coverage and access gaps that remain, and to make healthcare more affordable and sustainable. But, "Medicare for All" is not the answer. As we've learned in Massachusetts, there is no single solution that will cure the many challenges of our complex healthcare system. Instead, we should focus on securing and building upon all that is currently working. Let's defeat the challenges to the ACA, make the necessary refinements, and secure its full implementation nationwide.

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Posted by Steve Walsh on Mar 15th, 2018 12:06pm

The following blog post is from Guest Commentator Steven Defossez, MD, Vice President for Clinical Integration at the Massachusetts Health & Hospital Association:

Finally, common sense has prevailed over a single nurses' union that sued a Massachusetts hospital to try and block mandatory flu vaccination for healthcare workers.

A Suffolk Superior Court judge has dismissed the Massachusetts Nurses Association (MNA) lawsuit that challenged Brigham and Women's Hospital's mandatory flu vaccination policy for employees.

A number of hospitals in Massachusetts require caregivers to receive flu vaccines each year, unless they have a medical or religious exemption, in which case the healthcare worker needs to wear a face mask in the presence of patients. All hospitals in the commonwealth strongly encourage their workers to get vaccinated and offer free flu vaccine to their employees.

For years, the MNA has tried to make one non-starter argument after another against mandatory flu vaccination, garnering strong opposition as far back as 2014 from members of the general public and physicians, who de-bunked the union leadership's incorrect claims that there were a number of adverse events related to flu vaccine, when in fact serious health risk due to flu vaccine is rare. The Boston Globe even wrote an editorial supporting mandatory flu vaccination for all healthcare workers in 2014. The nurses' union's latest objections - that mandatory vaccination is an overreach and unfair given that the vaccine sometimes has limited efficacy  - didn't hold water with the judge or with medical professionals. The Boston Herald article on the judge's decision cites epidemiologists who "urge the vaccination of hospital personnel, given the vulnerable population they care for," and note that "even a vaccine poorly matched with the virus during a particular season may provide some protection."

Our hospitals are taking the lead in this important public health and safety effort, but here in Massachusetts, healthcare employees can and should be universally immunized against influenza each year. MHA strongly supports the establishment of state policies that would require all members of the healthcare workforce without a religious or medical exemption to be vaccinated.

Hospital patients who contract the flu are the most susceptible to severe complications or even death from this illness. Getting a flu shot is safe, it's the best way to protect against the influenza virus, and it can prevent unnecessary anxiety and waste of healthcare resources. As healthcare providers, our members are responsible for promoting public health and should be role models. As centers for care, hospitals will continue to be proactive in ensuring the safest conditions possible for their patients, families, and healthcare professionals alike.

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Posted by Steve Walsh on Dec 13th, 2017 5:00pm

The Massachusetts Health & Hospital Association (MHA), the Organization of Nurse Leaders (ONL), the Massachusetts Council of Community Hospitals (MCCH) and the Conference of Boston Teaching Hospitals (COBTH) have come together to launch the Coalition to Protect Patient Safety.  The Coalition is a joint effort formed in response to the political efforts of one union, the Massachusetts Nurses Association (MNA), who has a proposed ballot question to implement one-size-fits-all staffing requirements in every hospital unit statewide.  The proposed question is expected to go before voters in 2018.  The Coalition’s mission is to protect our state’s healthcare system and patients from the costs and consequences of rigid, government-mandated nurse staffing ratios.

Massachusetts is home to some of the best healthcare institutions in the world because our top priorities have always been patient safety and high quality of care. Hospitals across the Commonwealth work collaboratively with their teams of doctors, nurses, and a wide range of other clinicians and support staff to achieve these goals.

Today’s rapidly evolving healthcare delivery system is focused on flexible, integrated care. Registered nurses are a crucial, respected and deeply-valued part of any hospital caregiving team, but continued flexibility and ability of those teams to adapt to changing circumstances for each patient at each hospital is essential. This proposed question would threaten each individual hospital’s ability to respond to the specific needs of their patients and community, compromising safety.

In recent years, the Commonwealth and the country have been grappling with the rising cost of healthcare. If passed, this nurse staffing measure would increase health spending by more than $880 million each year, a burden that will be felt across the healthcare system. Patients would see higher premiums, deductibles, and taxes at a time when many Massachusetts families are already struggling. Hospitals would be forced to cut vital public health programs and services, such as cancer screenings, opioid initiatives, mental health treatment, early childhood intervention, domestic violence programs and pre- or post- natal care. Some smaller community hospitals would be unlikely to survive.

The MNA, which represents less than 25 percent of nurses in Massachusetts, has pushed government mandated staffing ratios at the State House for more than 20 years without success. In fact, despite being considered at length in dozens of states, staffing ratios have only been adopted in California where there is no evidence that they have improved quality of care. It’s easy to say that “having more nurses is a good thing,” but Massachusetts voters must be presented with all of the facts. MNA leadership points to studies that they claim support ratios; however, research has not provided a specific number that would constitute “the right” level of nurse staffing, because no such number exists. What this ballot measure would do is take patient care decisions away from the healthcare professionals at the bedside, and increase healthcare costs in the process.

The Boston Herald got it right in its editorial last week when the paper called the MNA’s petition “'the most irresponsible approach to healthcare — especially in an era of rising costs — that has ever come down the pike.” The Coalition to Protect Patient Safety agrees, and we look forward to a thoughtful discussion in the coming months about how this measure would actually be detrimental to patient safety – which is precisely why we’re against it.

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Posted by Steve Walsh on Nov 22nd, 2017 9:47am

Steve Walsh joined the Massachusetts Health & Hospital Association (MHA) as president and CEO in November 2017.

A member of the American College of Health Care Executives (ACHE), Walsh previously served as the Executive Director of the Massachusetts Council of Community Hospitals (MCCH), an organization he led since 2014. During his tenure, Walsh worked with executives from Massachusetts healthcare institutions to promote and drive innovative change in healthcare delivery, policy and regulation.

Prior to MCCH, Walsh served six terms in the Massachusetts House of Representatives and was appointed chairman of the House Committee on Health Care Financing in 2011. He oversaw the drafting and passage of the Commonwealth's 2012 landmark healthcare payment reform law, Chapter 224. This legislation incentivized utilization of alternative payment methodologies and investment in community health, while encouraging patient empowerment and primary care. He was also a conferee of Chapter 288 of the Acts of 2010, the Commonwealth's small business health care legislation.

Walsh is a graduate of Wesleyan University, the New England School of Law, and the Harvard Kennedy School of Government.

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Posted by (name unknown) on Oct 20th, 2017 11:28am

“Fake news” has unfortunately become part of our culture. This time, however, we have an opportunity – and in fact an obligation – to correct it. If you needed additional proof that the Massachusetts Nurses Association union is focused less on patient care and more on trying to damage hospitals to advance its misguided upcoming ballot initiative to force mandatory staffing ratios, look no further than the recent false press release distributed by the MNA. The nurses’ union untruthfully said Berkshire Medical Center, which was the target of a recent union strike action, had withdrawn its unfair labor practices complaint against the union – when in reality it was the MNA that withdrew a complaint against the hospital.

MNA issued a retraction, of course, and claimed their leaders had “mis-read” the National Labor Relations Board actions. In the union’s zeal to attack Berkshire, they missed something very important – the facts – as they consistently have done in their efforts to advance their mandatory ratios agenda.

And the facts are clear about our state’s healthcare system. Massachusetts hospitals work collaboratively with their teams of doctors, nurses, and a wide range of other clinicians and support staff to achieve some of the best healthcare outcomes for quality and patient safety in the country. Those are the facts.

The Berkshire incident is the latest in a pattern of reckless MNA actions designed to politicize contract negotiations and inflict harm on hospitals.  A June 2017 MNA memo issued before a Tufts Medical Center nurses strike also indicated that the union leadership wanted to pick a strike date “most harmful to the hospital.”

In their own words in both situations, it’s clear that the union is more interested in hurting hospitals than it is in helping patients, or even its own members. That the MNA attempted to validate the Berkshire falsehoods using quotes from their members that were clearly based on inaccurate information provided by the union leadership is particularly disturbing.

There was one true statement in the MNA’s erroneous press release, but it’s not about the hospital, it really reflects the MNA’s own behavior: "This charge was obviously just a public relations ploy, one of many baseless accusations[.]” The union’s false claims and disingenuous actions throughout both the Tufts and Berkshire contract negotiations have been hypocritical and self-serving. And this fact should not be forgotten as the public debate over this issue takes shape over the coming year.

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Posted by (name unknown) on Oct 13th, 2017 2:06am

President Trump's irresponsible decision to discontinue federal insurance cost-sharing reduction subsidies is a devastating one-two punch coming on the heels of yesterday’s Executive Order that could undermine current consumer insurance protections – Protections that are especially important to older, sicker, and poorer Americans with private or work-sponsored insurance.

These announcements will be particularly disruptive to the Massachusetts healthcare system. The commonwealth has been structuring the upcoming 2018 open enrollment offerings  - now just weeks away - based on some $146 million in previously agreed-to federal support. The declaration that federal subsidies will cease “immediately” means millions of low-income Americans, including 80,000 Massachusetts residents, could find themselves unable to afford their health insurance practically overnight, and under the executive action allowing cross-state insurance sales through association health plans, many more individuals will see their coverage costs skyrocket, even if they have commercial insurance (through a job or otherwise), simply because they are older or have a pre-existing condition like asthma or diabetes.

The President claims he’s thrown these grenades on Obamacare so Congress will “fix it.” That’s like burning down your house so you can renovate your front porch.

Thursday’s Executive Order was correctly criticized by numerous healthcare organizations and stakeholders, including the American Hospital Association, and today Massachusetts Attorney General Maura Healey joined a lawsuit filed by the Attorney General of California in an effort to prevent the president from cutting off the CSR payments.

MHA stands united with our entire Congressional delegation and state leaders including Governor Charlie Baker in condemning these reckless, destructive moves, and fully supports Healey’s actions. We are thankful to have her as a partner in our mission to deliver the best and safest possible patient care.

By ending federal insurance subsidies for poor patients and weakening insurance protections through the Executive Order, the Trump administration has made Friday the 13th a very unlucky day for the entire nation's healthcare community and anyone who may need care - which is every single American.

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Posted by (name unknown) on Jul 31st, 2017 10:16am

The Massachusetts Health & Hospital Association and our members are immensely relieved that the latest GOP Senate healthcare proposal was defeated. Now Congress can – and should – focus on our nation's most important short-term healthcare issue, which is stabilizing the individual insurance market. 

We are extremely grateful to our two senators for their steadfast opposition to the repeal efforts, and for their outstanding leadership throughout the Senate deliberations. MHA looks forward to continued collaboration with our entire congressional delegation, the Baker Administration and all other stakeholders to build upon the solid foundation of the Affordable Care Act and make good healthcare policy better.

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