Task force to review how MA hospitals put money to use in community

Members of the task force outlined their goals and expectations at Wednesday's meeting

This Thursday, July 30, 2015, file photo shows an exam room in a hospital in Alabama. A study of older patients hospitalized for common illnesses shows those who got most of their care from women doctors were more likely to leave the hospital alive than those treated by men. The results were published by JAMA Internal Medicine on Monday, Dec. 19, 2016. (AP Photo/Brynn Anderson, File)

BOSTON (STATE HOUSE NEWS SERVICE) – A new health care task force convened by Attorney General Maura Healey is seeking to update the state’s guidelines for community benefits provided by nonprofit hospitals, with several members calling for a focus on maximizing resources for a broader impact on overall health.

After spending the next seven months reviewing the community benefits program, the task force plans to recommend updates to guidelines first put in place in 1994 and last updated in 2009.

“How can we most strategically leverage what we’ve got to ensure the best and optimal outcomes for our communities?” Healey asked the 16-member task force at its first meeting Wednesday.

She said she recently learned from her staff that 75 percent of medical dollars go to the management of chronic conditions.

“I thought that was really significant that we’re spending so much more money managing chronic conditions, and what does that mean about where we’re at, because if that’s the case, we know that smart spending on health care can’t start at the pharmacy or at the doctor’s office,” Healey said. “We need to think about what we’re doing with education and prevention.”

Under the voluntary program, hospitals and health maintenance organizations submit annual reports to the attorney general’s office detailing the benefits they provide to residents of their area. Between 2010 and 2015, hospitals and HMOs reported a total of more than $750 million in community benefit spending each year.

Karen Tseng, the deputy chief of Healey’s health care division, said community benefits are primarily divided into two categories: free or discounted care to patients, and programs addressing a community’s documented health needs. The institution can either directly develop and offer its own programming, or support another organization’s efforts with grants.

Tseng said the task force’s work will focus on aligning the community benefit guidelines with related standards used by the IRS and state Department of Public Health; improving coordination among participants; and developing ways to improve transparency and measurement of outcomes.

“I know that we’re not going to come up with some perfect, final solution,” Tseng said. “That’s not the nature of public health.”

Members of the task force outlined their goals and expectations at Wednesday’s meeting, with several saying collaboration among different hospitals could lead to more efficient attempts to meet the same health goals. Addressing health disparities and social determinants of health — housing, education, economic status and other non-medical factors that affect a person’s health outcomes — were other common themes.

“How do we look at, given the allocation of resources, the most strategic allocation of resources so that we avoid duplication and really move the needle on population health in a way that makes sense?” said Enid Eckstein, who worked with fellow task force member Paul Hattis on an October 2016 report examining community benefits in Massachusetts.

The report recommended efforts to encourage coordination among hospitals, an alignment of the AG’s guidelines with other state rules and federal guidelines, and an evaluation process to determine effectiveness of the programs.

Margaret Reid of the Boston Public Health Commission said she hoped the task force would try to encourage “amplification” of resources, as the large number of hospitals in the Boston area would have the “potential for collective impact” through community benefits.

Michael Botticelli, executive director of the new Grayken Center for Addiction Medicine, said he hoped to see recommendations that would “squarely deal” with substance use issues. Susan Sherry of Community Catalyst called for a “meaningful” community engagement process that would back up numbers and data with accounts of residents’ experiences.

Jody White, the CEO of Circle Health and Lowell General Hospital, said he is interested in helping standardize “how we move data around” and “furthering the cause of making our community benefits most effective.”

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