Coakley Issues Benefits Guidelines for Hospitals and HMOS
BOSTON, Mass. – As part of her ongoing effort to address unmet health needs in the Commonwealth, Attorney General Martha Coakley today issued new Community Benefit Guidelines for non-profit, acute care hospitals and health maintenance organizations (HMOs).The guidelines are the product of a year-long review by an Advisory Task Force of key stakeholders who share the common goal of improving the health of communities across the state. Under the guidelines, hospitals and HMOs submit annual reports to the Attorney General on their community benefit programs and expenditures, enabling both Attorney General oversight and public scrutiny of non-profit health care institutions.
“These changes will make our Community Benefits program an even more effective way to ensure that non-profit health care entities are meeting community health needs and doing their part to ensure access to quality health programs. These revisions clarify our expectations of how key health care players should respond to community health needs and will improve transparency and accountability in community benefit reporting,” said Attorney General Martha Coakley. “These revised guidelines represent a great deal of hard work and thoughtful contributions by members of the Task Force.”
Revision of the guidelines comes at a critical time for Massachusetts health care. Health care reform has substantially increased insurance coverage, but access to affordable, quality health care remains a challenge for many, particularly in the economic downturn. Community benefits programs play an important role in our efforts to respond to these challenges. For example, hospitals and HMOs have assisted low-income patients manage chronic diseases like diabetes, provided free dental examinations and sealants for children, provided free pre-natal care to expectant mothers in areas with high rates of infant morbidity and mortality, and funded programs to curb childhood obesity.
The Community Benefits Program, originally established by the Attorney General’s Office in 1994, sets forth principles to guide hospitals and HMOs as to how they should fulfill their responsibilities to provide benefits to their communities commensurate with their tax- exempt status. The Attorney General’s program is a unique, non-regulatory approach that calls upon hospitals and HMOs to identify unmet community health needs and commit resources to address those needs.
The Advisory Task Force on Community Benefits, reached consensus on stronger guidelines that create clear expectations for how hospitals and HMOs should dedicate resources to improve the health in their communities.
The new guidelines:
* require goal setting and measurement for community benefit programs;
* encourage alignment of community benefit activities with statewide health priorities, such as chronic disease management and reducing health disparities;
* streamline and standardize the reporting format; and
* encourage pre-planning and community involvement in the development of community benefit programs;
* recommend hospital debt collection practices that balance the needs of consumers burdened with medical debt with the needs of providers to seek reimbursement for their services.
The revised guidelines will take effect for the fiscal year beginning in October 2009. The Attorney General’s Office plans to partner with the Massachusetts Hospital Association, the Massachusetts Association of Health Plans and others to provide training on the new Guidelines to hospital and HMO leadership and staff across the state.
The members of the Attorney General’s Community Benefits Advisory Task Force are:
· Barbara Anthony, Executive Director of Health Law Advocates,
· Lori Berry, the Executive Director at the Lynn Community Health Center,
· Dr. Mary Lou Buyse, the President and CEO of the Massachusetts Association of Health Plans,
· John Erwin, the Executive Director of The Conference of Boston Teaching Hospitals,
· Matthew Fishman, Vice President of Community Health, Partners Health Care,
· Dr. Brian Gibbs, Director of the Program to Eliminate Health Disparities at Harvard’s School of Public Health,
· Charles Joffe-Halpern, President of Ecu-Health Care in North Adams and Chairman of Board of Health Care For All,
· Kerry Mello on behalf of Ellen Banach, Senior Vice President of Strategic Services at Southcoast Hospital Group in New Bedford,
· Lynn Nicholas, The President and CEO of the Massachusetts Hospital Association,
· Fawn Phelps, Policy Director of Health Care for All,
· Dr. Lauren Smith, Medical Director of the Commonwealth’s Department of Public Health,
· Zoila Torres-Feldman, Kit Clark Senior Center.
The task force was chaired by Attorney General Martha Coakley with assistance from Assistant Attorney General Lois Johnson, Health Policy Analyst Kimberly Henry, and Division Chief Quentin Palfrey of Attorney General Coakley’s Health Care Division and Division Chief David Spackman of Attorney General Coakley’s Non-Profits/Public Charities Division.
The guidelines are available on the Attorney General’s website at: www.mass.gov/ago/communitybenefits.
