Overall emergency department visits were down about 20% in September compared to the same prior-year period, which is often a primary referral source for hospitals. Small

But many Massachusetts systems were taking in more behavioral health cases through the ED, which isn’t an ideal setting.

“We have heard anecdotally from hospitals that they are struggling with ED volumes specific to behavioral health patients, and are seeing a spike in ED boarding,” said David Seltz, executive director of the HPC, said during the commission’s board meeting Wednesday. “That is a trend that the secretary (of state) is very concerned about.”

COVID-19 relief funds helped soften the blow for Massachusetts hospitals, according to data from 37 of 61 of the commonwealth’s acute-care facilities. Federal and state relief funds could not offset the sharp decline in revenues in March and April, but they helped neutralize losses in May and led to double-digit positive margins in June and July. Though, one commissioner cautioned, those large gains may not account for clawbacks of overpayments or when funds weren’t used appropriately.

Hospitals are adapting to payer mix changes, which have been trending toward coverage that nets lower reimbursement levels. Since March, MassHealth enrollment has increased 7.8% as commercial enrollment declined 1.6%, often stemming from residents who lose their employer-based coverage. Medicare enrollment in Massachusetts increased 3.2% over that span.

As reported across the country, COVID-19 is disproportionately impacting people of color. Black and Hispanic commonwealth residents accounted for 38.3% of COVID-related inpatient discharges from April to June compared to 20.5% of non-COVID discharges.

Providers were most concerned about the socioeconomic impacts of COVID-19 on patients related to job loss, evictions, food insecurity and other consequences. The next-highest concerns involved staff burnout, mental and physical effects on COVID-19 patients, and access to in-person care.


Source: Small physician groups struggle with telehealth, Massachusetts commission finds

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