Atrius Health Weighs in on FY’17 House Budget

Government & Policy Cost of Care Transforming Care Healthcare Delivery

| Posted On Apr 25, 2016 | By: Atrius Health

Atrius Health appreciates the efforts of the House Ways and Means Committee in presenting H.4200, a well-balanced fiscally responsible FY’17 budget proposal that protects the programs and services critical to ensuring a healthy Commonwealth.  Next week the House will begin deliberations on the budget and there are several items that are of particular interest to Atrius Health and we would encourage members of the House to consider our positions on the following issues:

• We oppose Amendment #550 – Specialty Provider Licensure.  The proposed amendment would require extensive changes and would impose significant new regulatory requirements for certain physician office practices.

    In some cases, these physician office practices would not be permitted to provide their current specialty services, since the Department of Public Health (DPH) is currently not issuing any additional Determination of Need (DON) certifications that would be required under this proposed amendment. These changes would require that many groups of specialty providers become licensed clinics. To become licensed clinics, they would likely have to undergo massive changes in facility design, operating procedures, and documentation at a time when access to many specialties is already difficult and costs are too high. Physician offices that offer these services today are the lowest cost alternative at time when the state is working to decrease overall costs of healthcare expenses and provide more alternatives for care in less intensive settings whenever appropriate. The proposed amendment is just not aligned with these goals. In terms of ensuring quality patient care, the Board of Registration in Medicine and Massachusetts Medical Society have already detailed guidelines for procedures referenced in this amendment so that physician office practices will promote patient safety and meet acceptable facility and other standards that are appropriate for physician office practices. A more thorough discussion with key stakeholders of this complex issue is warranted.

• We support Amendment #1099 – Improving Patient Care. The amendment would change current state law to allow certified medical assistants to administer immunizations under the direct supervision of a primary care provider. Atrius Health employs hundreds of certified medical assistants who play a vital role as part of our patient care team. Like many providers who support this change in existing state law, Atrius Health works to ensure that all of our patients are current on recommended vaccines where indicated; however the increasing need to provide vaccinations to our patients places additional burden on our clinicians. Existing state law (MGL Chapter 94C) does not authorize certified medical assistants to administer vaccinations, and only permits certain licensed professionals to do so. This restriction adds unnecessary costs to healthcare by requiring such licensed professionals to perform a function that can be safely performed by certified medical assistants. Massachusetts would join a growing list of states that expressly permit medical assistants/certified medical assistants to administer immunizations to patients.

• We support Amendment #105 – MassHealth Reimbursement Rates for Home Health Services. The amendment would require that a comprehensive review be conducted on home health rates. Payment rates for home health nursing, therapies and aides have not been reviewed since 2007. Current rates for nurses are based on 2005 data and were cut in 2008. Continuous skilled nursing agencies, which provide intensive medical care in the home over consecutive hours, are having extreme difficulty recruiting and retaining nurses because of inadequate MassHealth rates.