Commission Seeks Input On Hospital Grant Criteria
With millions of dollars in play, a state agency is crafting regulations for grants to hospitals and will spend the rest of the summer hearing input on how those funds should be doled out.
The Health Policy Commission approved draft regulations for the administration of CHART grants, which are funded in part by a one-time fee levied on the state's most asset-rich hospitals.
"The purpose of this fund is not to bail out failing hospitals," HPC Executive Director David Seltz told the commission Thursday. He said the purpose is to invest in hospitals.
"Everyone agrees behavioral health is broken in this state," said Paul Hattis, an HPC board member and consumer advocate. "I don't know if that is going to be the major area that we invest in."
Other considerations include whether the grants should be smaller awards that can be spread "across the system" or "large, targeted rewards," Seltz said.
Last year's health care cost control law limited the grants so they exclude major teaching hospitals, for-profit hospitals, hospitals whose relative prices are higher than the statewide median relative price, and the commission can further limit eligibility.
The grants are funded out of the Distressed Hospital Fund, but the HPC has dubbed it Community Hospital Acceleration, Revitalization and Transformation, or CHART.
The one-time fee on hospitals and insurers will generate $74.2 million in the first year, $39.9 million of which will go into the fund. Over the second, third and fourth years, the fund is expected to receive $26.3 million annually, according to Seltz.
"It's always perplexed me that we don't have any definition for distressed," said Wendy Everett, the commission's vice chairwoman, who noted the factors are "exclusionary." She said, "You can't be for-profit, but nowhere have we dealt at all with what does distressed mean."
Hattis said, "In some ways these hospitals are just bricks and mortar. It's really the communities they serve that might be challenged."
Commission Chairman Stuart Altman said the fund's name is "a carryover" from prior law, and said, "some of our most distressed hospitals" are not among the 30 hospitals deemed eligible as of July 10.
Associated Industries of Massachusetts CEO Rick Lord, who represents employers on the board, said the grants, if they work as intended, could drive down health care costs.
"The fact that we've changed the focus of the fund from simply looking at distressed hospitals to enabling community hospitals to innovate and deliver more efficient care, I think has the potential to be very positive. You know, obviously we're at the very beginning of this process," Lord said. "To the extent that we identify more efficient delivery systems, that should help the cost issues."
Seltz said the commission hopes to have the regulations in place by September so it can award the first round of grants by the end of the year, which he said would be a portion of the roughly $40 million available.
"It just seems rather fast given that this is such an important part of this commission," said board member Marylou Sudders, an expert in behavioral health.
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