BOSTON (SHNS) – Labor challenges across the health care landscape are one of the top areas of focus for the Health Policy Committee this year, and industry leaders and business groups suggested Wednesday that the problem is powerful enough to cut through. the rest of the priorities of the regulatory agency.
While many other aspects of the state’s economy have rebounded from the impacts of COVID-19, the pandemic exposed and deepened labor shortages that have made it more difficult for Bay Staters to access the care they need.
HPC Executive Director David Seltz told his agency’s revised advisory council that addressing hiring and retention difficulties is at the top of the commission’s agenda this year, along with efforts to strengthen cost control tools. of health care, to reduce disparities in care provided to different demographic groups, to improve controls on pharmaceutical prices and reduce administrative complexity in the industry.
“None of this gets done unless we really address the workforce issue,” Emerson Hospital President and CEO Christine Schuster responded after Seltz presented HPC’s priorities at a board meeting Wednesday. “It’s really a two-pronged approach. Short term, we need more than gum and duct tape and agency staff to fill our staffing holes, and long term, we need to work on the pipeline and how we can really address the pipeline issue so that in five, 10, 15 years, we don’t continue to have these problems.”
Other council members were quick to jump in and argue that the worker shortages are marbled across the health care industry’s other pressure points, rather than an independent, separate trend.
With analysts at HPC expecting the next annual cost trends report to show a big increase in health care spending, Massachusetts Home Care Alliance Executive Director Jake Krilovich said, “I don’t think we can solve the cost control problem without addressing the workforce issue.”
Krilovich said there are thousands of older Bay Staters waiting for openings for home care services and “hundreds of referrals on a daily basis that home care agencies and home health agencies are turning away from hospital discharges,” plus many children with complex medical needs unable to meet their demand for services.
“All of that ultimately leads to pushing these patients into a higher-cost setting,” he said.
Industry leaders and elected officials have been sounding the alarm for months about health care workforce shortages, which to some extent mirror the hiring and retention struggles of employers in many other industries.
Massachusetts Health and Hospital Association evaluated last fall that hospitals across the state lack about 19,000 full-time workers, and former Gov. Charlie Baker he warned before leaving office that understaffing creates both “real cost consequences” for patients and “quite severe” financial headaches for providers.
State lawmakers introduced bills aimed at easing the strain, including legislation to reform rate setting for home care workers. Top Democrats have not indicated any specific plans for addressing workforce challenges, however, instead targeting prescription drug prices and containing health care costs. as their early priorities.
Wednesday’s meeting highlighted the tensions between different segments of the industry that lawmakers and regulators will have to navigate.
Lora Pellegrini, president and CEO of the Massachusetts Association of Health Plans, said insurers and providers participated early in HPC’s efforts to contain health care costs, and asked the Massachusetts Biotechnology Council — the head of corporate affairs, Zach Stanley, also sits on HPC’s advisory panel – and the pharmaceutical industry more broadly to face the same scrutiny.
“We need to get to the root cause of the drivers of health care costs. We know what they are. We know that the price of prescription drugs is one of the main drivers. Trying to mask it until then having a cost-sharing conversation, I think is very disingenuous to the consumer,” Pellegrini said. “I think one priority, and you have it here, is that we really have to reduce pharmacy costs. We’ve had some success at MassHealth. We need to hold the pharmaceutical industry accountable for driving up drug costs.”
Stanley, in his remarks, was not targeting insurers or MAHP. Instead, it focused primarily on the need to accurately collect data on pharmaceutical costs and expenditures.
“Pharmaceutical spending is perhaps unique in all respects in that it is measured in two different ways, both gross and net. That’s confusing, if nothing else, and probably leads to incorrect conclusions at the end of the day,” Stanley said.
Schuster suggested that policymakers weigh options such as making hospital care more available through telehealth that patients can use from home, warning that the current crisis makes services harder to access.
“We have too many wait times in almost every system to get people to see a doctor or an advanced practice provider,” Schuster said. “I have seen throughout the pandemic. It gets worse and worse.”
Colin Killick, executive director of the Disability Policy Consortium, said his group supports a push by union leaders for the state to offer personal care attendants an “immediate emergency rate of $20 an hour.”
“It’s terrible there. People are really struggling to find PCAs when fast food can outbid and pay more than PCA wages,” he said.
One of the advisory council’s newest members, the Department of Youth Services’ Northeast Regional Medical Director, Jeanette Callahan, suggested that the HPC combine two of its top priorities — addressing the workforce crisis and eliminating unnecessary administrative barriers — in a single article.
“It is because of the unnecessary administrative complexity that people are not going into my field. That’s why people are pulling out of my field,” said Callahan, who also works as a pediatrician at Cambridge Health Alliance. “I deal with this every day. Administrative complexity has nothing to do with patient care and everything to do with with the reason why our workforce is shrinking.”
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