Massachusetts officials and insurers are implementing various measures to address an increase in respiratory illness affecting hospital capacity.
The Boston Herald reported the news Jan. 13 after obtaining a memo to top health officials from Massachusetts Health and Human Services Secretary Kate Walsh.
The memo, in part, stated that hospitals in Massachusetts have agreed "to commence discharge planning and care coordination as early as practicable" for patients as they grapple with record occupancy levels, workforce shortages, and the circulation of influenza, COVID-19 and respiratory syncytial virus, according to the Herald.
State officials also confirmed to Becker's the Herald's report that some health plans, including MassHealth, a state program that combines Medicaid and the Children's Health Insurance Program, have waived the need to obtain prior authorization for short stays in post-acute care facilities.
Blue Cross Blue Shield of Massachusetts and Massachusetts Association of Health Plans members specifically agreed to voluntarily waive prior authorization from Jan. 9 through April 1, Ms. Walsh said, according to the Herald. She also noted that the waiver applies solely to admissions from acute care hospitals to sub-acute care and rehabilitation facilities and that health plans can conduct "retrospective and concurrent" reviews during the time period "to determine appropriateness of level of care."
According to information the Massachusetts Executive Office of Health and Human Services shared with Becker's, hospitals "should begin discharge planning as soon as possible during each patient's admission and do not need to wait for a prior authorization to discharge for short stays in post-acute facilities." The insurers' agreement to suspend prior authorization requirements will allow patients to be discharged more quickly to rehab and the inpatient beds made available for other patients more quickly, the office said in an email.
Hospitals are also encouraged to work to improve their staffing plans to fully staff all licensed adult medical/surgical beds to increase bed availability, the email said.
"Due to rising cases of respiratory illness, [the Massachusetts Executive Office of Health and Human Services] implemented these measures to ensure people are getting the care they need while reducing strain on the healthcare workforce," an EOHHS spokesperson said in a statement shared with Becker's. "We encourage everyone to get vaccinated against respiratory viruses like RSV, COVID and flu in order to reduce the severity of illness."
Read the full Herald report here.