Inpatient Hospital Discharge Database Documentation Manual
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Health Care in Massachusetts: Key Indicators
DHCFP Health Care in Massachusetts: Key Indicators November 2008 Deval L. Patrick, Governor JudyAnn Bigby, Secretary Commonwealth of Massachusetts Executive Office of Health and Human Services Timothy P. Murray Sarah Iselin, Commissioner Lieutenant Governor Division of Health Care Finance and Policy Introduction About this Report Table of Contents Health Care in Massachusetts: Key Indicators is a quarterly report from the Division of Health Care Finance and Policy. Key Indicators provides an overview of the Massachusetts health care landscape through data reported by providers, health plans, government, and surveys of Massachusetts residents and employers. The Division received positive feedback from readers of prior editions of this report and has incorporated suggestions for improvement where possible. We continue Health Insurance Coverage 2 to strive to make this report as useful as possible and welcome your feedback. In this edition of Health Care in Massachusetts: Key Indicators, the Division found that since the implementation of Employer Survey 4 health reform over 442,000 additional people have obtained health insurance. Nearly half of that growth (187,000) has been in private group coverage (i.e., through employers) or individual purchase. In the first six months of the Health Uncompensated Care Pool/ Safety Net, volume in hospitals and community health centers decreased by 36% compared to the same period in the prior year. Payments decreased by 38% over the same period. This edition also includes updates of the following: Health Safety Net 7 cost trends in health insurance premiums compared to the Commonwealth Health Insurance Connector Authority’s affordability schedule for 2008, health plan financial performance, hospital financial performance, and other indica- Health Insurance Premiums 11 tors of health care in Massachusetts. -
Massachusetts Hospitals' Community Benefit Initiatives
A Commitment to Community: Massachusetts Hospitals’ Community Benefit Initiatives 2020 Report Region 3 Region 1 Region 2 Region 4 Region 5 Baystate Health • Baystate Franklin Medical Center • Baystate Medical Center • Baystate Noble Hospital • Baystate Wing Hospital Berkshire Health Systems • Berkshire Medical Center Partners HealthCare • Brigham and Women’s Faulkner Hospital • Fairview Hospital • Brigham and Women’s Hospital Beth Israel Lahey Health • Cooley Dickinson Health Care • Anna Jaques Hospital • Martha’s Vineyard Hospital • Beth Israel Deaconess Hospital – Milton • Massachusetts Eye and Ear Infirmary • Beth Israel Deaconess Hospital – Needham • Massachusetts General Hospital • Beth Israel Deaconess Hospital – Plymouth • Nantucket Cottage Hospital • Beth Israel Deaconess Medical Center • Newton-Wellesley Hospital • Beverly and Addison Gilbert Hospitals • North Shore Medical Center • Lahey Hospital & Medical Center Shriners Hospitals for Children-Boston • Mount Auburn Hospital • New England Baptist Hospital Signature Healthcare Brockton Hospital • Winchester Hospital South Shore Hospital Boston Children’s Hospital Southcoast Hospitals Group Boston Medical Center Sturdy Memorial Hospital Cambridge Health Alliance Tenet Healthcare • MetroWest Medical Center Cape Cod Healthcare • Saint Vincent Hospital • Cape Cod Hospital Trinity Health of New England • Falmouth Hospital • Mercy Medical Center Dana-Farber Cancer Institute UMass Memorial Health Care Emerson Hospital • UMass Memorial Health Alliance – Clinton Franciscan Children's Hospital -
Lawrence General Hospital
Massachusetts Hospital Payment Variation 2015 2016 Share of # Hospital Relative Relative Commercial MA Acute Hospital Commercial Relative Price (Weighted Average 2016) Price Price Payments Statewide Results Published By CHIA February 2018 1 Baystate Noble 0.681 0.682 0.2% Baystate Noble Hospital 2 Holyoke Medical Center 0.722 0.728 0.2% Holyoke Medical Center 3 Lawrence General 0.754 0.736 0.4% Lawrence General Hospital 4 Anna Jaques 0.756 0.743 0.5% Anna Jaques Hospital 5 Baystate Wing 0.749 0.752 0.2% Baystate Wing Hospital 6 Cambridge Health Alliance 0.797 0.754 0.6% Cambridge Health Alliance 7 BIDH - Milton 0.760 0.757 0.4% Beth Israel Deaconess- Milton 8 Massachusetts Eye & Ear 0.833 0.760 Massachusetts Eye & Ear 9 Heywood Hospital 0.752 0.763 0.4% Heywood Hospital 10 Signature Brockton 0.785 0.787 0.7% Signature Brockton Hospital 11 Mercy Medical Center 0.806 0.796 0.6% Mercy Medical Center 12 HealthAlliance 0.781 0.804 0.4% HealthAlliance Hospital 80% of Average 13 Emerson 0.846 0.824 1.1% Emerson Hospital 14 Steward Morton 0.855 0.837 0.4% Steward Morton Hospital 15 Milford Regional 0.840 0.840 1.1% Milford Regional Medical Center 16 Lowell General 0.822 0.850 1.6% Lowell General Hospital 85% of Average 17 Northeast Beverly 0.867 0.851 1.3% Northeast Hospital 18 MetroWest 0.856 0.853 1.0% MetroWest Medical Center 19 Steward Holy Family 0.859 0.857 0.7% Steward Holy Family Hospital 20 Winchester Hospital 0.892 0.865 1.6% Beth Israel Deaconess - Plymouth 21 BIDH - Plymouth 0.861 0.865 0.8% Winchester Hospital Underpaid Hospitals -
Massachusetts Acute Hospital and Health System Financial Performance Fiscal Year Data Through March 31, 2018 June 2018
Massachusetts Acute Hospital and Health System Financial Performance Fiscal Year Data through March 31, 2018 June 2018 About this Report The Center for Health Information and Analysis (CHIA) reports on the financial performance of the Commonwealth’s acute care hospitals and associated hospital health systems (HHS). As hospitals and HHS are evolving and expanding, CHIA is collecting quarterly financial data from HHS on a voluntary basis. Data submissions received from the HHS help develop a more complete understanding of the financial performance of an acute hospital in the context of the larger health system within which it operates. This report provides a quarterly update on profitability, liquidity, and solvency for the period ending March 31, 2018. All 61 acute hospitals and 14 of 30 HHS are included in this publication. Hospital Health Systems This section reports on the total margin of the health systems and the constituent acute hospitals. The HHS includes the results of operations at the system level including the acute hospitals and all other financially consolidated health care entities such as physician organizations, non-acute hospitals, foundations, and health plans, as well as non-health care entities. Hospital Health System Key Findings Of the six systems that reported a loss, five included at Of the 14 health systems that submitted data, eight were least one hospital that reported a profit. 1 profitable through March 31, 2018. In general, acute hospitals performed better than their Four of the eight systems with positive total margins had respective health systems. negative operating margins, indicating that these systems Thirteen health systems reported a current ratio at or above rely on non-operating revenues to achieve overall 1.0, a benchmark which indicates short-term solvency. -
Fallonhealth.Org Find Your Doctor
Your Network Get more choice with Select Care NETW O O M R H K D H A O S E R L B E SC C T H C E A R What you get • Greater choice at a competitive price. • Access to an expansive network that includes physician practices, community-based hospitals and medical facilities across the Commonwealth and southern New Hampshire. • Plus, worldwide emergency coverage! Please see the back of this insert for a full listing of participating Massachusetts, New Hampshire and Vermont hospitals in Select Care. Participating hospitals Select Care service area fallonhealth.org Find your doctor Just visit fallonhealth.org and follow these simple steps: • Click on “Find a doctor” in the members section, or on the home page. • Click on “Search our regional networks.” If you are looking for a specific provider, type his/her last name. Once you start typing, you will be given a list of providers to choose from. Within the search results, you will see if the provider accepts Select Care. • If you don’t have a particular provider in mind, you can use the advanced search option to search by ZIP code to find a provider convenient to you. You can use this advanced search option for specialists as well as for primary care providers. We update the provider listing on fallonhealth.org every day, so you can trust that you are seeing the most up-to-date information. You can also call our Customer Service Department to have a representative help you find the doctor you’re looking for. -
Health Care System ACUTE INPATIENT HOSPITALS
A B C D E 1 ACUTE INPATIENT HOSPITALS PARTICIPATING IN MASSHEALTH (June 2021) Has Inpatient 2 Health Care System Acute Inpatient Hospital Town Psychiatric Unit? 3 Beth Israel Lahey Health Anna Jaques Hospital Newburyport X 4 Heywood Healthcare Athol Hospital Athol 5 Baystate Health Baystate Franklin Medical Center Greenfield X 6 Baystate Health Baystate Medical Center Springfield X 7 Baystate Health Baystate Noble Hospital Westfield X 8 Baystate Health Baystate Wing Hospital Palmer X 9 Berkshire Health Systems Berkshire Fairview Hospital Great Barrington 10 Berkshire Health Systems Berkshire Medical Center Pittsfield X 11 Beth Israel Lahey Health Beth Israel Deaconess Hospital - Milton Milton 12 Beth Israel Lahey Health Beth Israel Deaconess Hospital - Needham Needham 13 Beth Israel Lahey Health Beth Israel Deaconess Hospital - Plymouth Plymouth X 14 Beth Israel Lahey Health Beth Israel Deaconess Medical Center Boston X 15 Beth Israel Lahey Health Beverly Hospital (aka Northeast Health) Beverly X 16 Boston Children's Hospital Boston X 17 Boston Medical Center Boston 18 MassGeneralBrigham Brigham & Women's Hospital Boston 19 MassGeneralBrigham Brigham and Women's Faulkner Hospital Boston X 20 Cambridge Health Alliance Cambridge Hospital Cambridge X 21 Cape Cod Healthcare Cape Cod Hospital Hyannis X 22 Steward Health Care Carney Hospital Boston X 23 MassGeneralBrigham Cooley Dickinson Hospital Northampton X 24 Dana Farber Cancer Institute Boston 25 Emerson Hospital Concord X 26 Cambridge Health Alliance Everett Hospital Everett X 27 Cape -
Table of Contents
Fallon Medicare Plus™ Central HMO Plan Provider Directory This directory is current as of September 2, 2021. This directory provides a list of Fallon Medicare Plus Central’s current network providers. This directory is for the Fallon Medicare Plus Central service area which includes all of Worcester County. To access Fallon Medicare Plus Central’s online provider directory, you can visit fallonhealth.org/medicare. For any questions about the information contained in this directory, please call our Customer Service Department at 1-800-325-5669, 8 a.m.–8 p.m., Monday–Friday (Oct. 1–March 31, seven days a week). TTY users should call TRS 711. This document may be available in an alternate format such as braille, larger print, or audio. For more information call our Customer Service Department at 1-800-325-5669. Issued: September 8, 2021 Table of contents Notice of nondiscrimination ................................................................................................................... ii Multi-language interpreter services ....................................................................................................... iii Section 1: Introduction What is the service area for Fallon Medicare Plus Central? ................................................................... v How do you find Fallon Medicare Plus Central providers that serve your area? .................................... v Section 2: List of Network Providers Primary care (PCPs) ............................................................................................................................. -
EMERGENCY CARE HOSPITALS by City
EMERGENCY CARE HOSPITALS By City You can go to any hospital listed below for emergency care. You do not need a referral. Your provider will make plans for you to go to one of our participating hospitals when you need to for all other care. Emergency care hospitals are open 24 hours a day, seven days a week. ATHOL Massachusetts General CONCORD Athol Memorial Hospital Hospital Emerson Hospital 2033 Main St. 55 Fruit St. 133 Old Road to Nine Acre Athol, MA 01331 Boston, MA 02114 Corner (978) 249-3511 (617) 726-2000 Concord, MA 01742 ATTLEBOROUGH New England Medical Center (978) 369-1400 Sturdy Memorial Hospital 750 Washington St. EVERETT 211 Park St. Boston, MA 02111 Whidden Memorial Hospital Attleboro, MA 02703 (617) 636-5000 103 Garland St. (508) 236-8111 St. Elizabeth’s Medical Center Everett, MA 02149 AYER 736 Cambridge St. (617) 389-6270 Deaconess-Nashoba Hospital Boston, MA 02135 FALL RIVER 200 Groton Ave. (617) 789-3000 Charlton Memorial Hospital Ayer, MA 01432 BROCKTON 363 Highland Ave. (978) 772-0200 Brockton Hospital Fall River, MA 02720 BEVERLY 680 Centre St. (508) 679-3131 Beverly Hospital Brockton, MA 02302 St. Anne’s Hospital 85 Herrick St. (508) 941-7000 795 Middle St. Beverly, MA 01915 Caritas Good Samaritan Fall River, MA 02721 (978) 922-3000 Hospital (508) 674-5741 BOSTON 235 North Pearl St. FALMOUTH Beth Israel-Deaconess Brockton, MA 02301 Falmouth Hospital Medical Center (508) 427-3000 100 Ter Heun Dr. 330 Brookline Ave. BURLINGTON Falmouth, MA 02540 Boston, MA 02215 Lahey Clinic (508) 548-5300 (617) 667-7000 41 Mall Rd. -
Tufts Navigator Handbook
Introduction Welcome to Navigator by Tufts Health Plan™ (“Navigator”). We are pleased you have chosen this Point of Service (POS) Health Plan. We look forward to working with you to help you meet your health care needs. This Member Handbook describes the Navigator Health Care Plan. Please note that italicized words in this document have special meanings. These meanings are given in Part 8 – Terms and Definitions (see Page 92). Navigator is a self-funded Plan, which means that the Group Insurance Commission (the “GIC” or “Commission”) is responsible for the cost of the Covered Services you receive. The GIC has contracted with Tufts Health Plan to offer you access to a network of health care professionals known as Tufts Health Plan (“Tufts HP”) Providers. Tufts Health Plan also performs certain services, such as claims processing, but it does not insure Plan benefits or determine your eligibility for benefits under the Navigator Plan. This Member Handbook will help you find answers to your questions about your benefits. Navigator Members have benefits for Covered Services according to the terms of this Member Handbook. Tufts HP administers your medical and behavioral health/substance use disorder benefits. Medical and Behavioral Health Plan - Tufts Health Plan administers Navigator, which provides the medical and behavioral health/substance use disorder benefits described in this Member Handbook. Details on your coverage and costs for medical services are described in Part 1 – Benefit Overview (see Page 14) and Part 2 – Plan and Benefit Information (see Page 30). Navigator Members are encouraged to receive medical and behavioral health/substance use disorder services from the Tufts Health Plan network of health care Providers. -
Fy 2018 Massachusetts Hospital Profiles Technical Appendix January 2020
CENTER FOR HEALTH INFORMATION AND ANALYSIS FY 2018 MASSACHUSETTS HOSPITAL PROFILES TECHNICAL APPENDIX JANUARY 2020 Publication Number 20-30-CHIA-02 CHIA FY18 Massachusetts Acute Care Hospitals (January 2020) TECHNICAL APPENDIX Table of Contents Introduction ....................................................................................................................................................................................... 2 Multi-Acute Hospital System Affiliation and Location ................................................................................................................... 3 Regional Definitions ..................................................................................................................................................................... 4 Special Designations.................................................................................................................................................................... 6 Hospital Types ............................................................................................................................................................................. 7 At a Glance ....................................................................................................................................................................................... 9 Acute Hospital Profiles: Services ................................................................................................................................................... -
114.1 CMR 41.00: Rates of Payment for Services Provided to Industrial Accident Patients by Hospitals
The Commonwealth of Massachusetts Executive Office of Health and Human Services One Ashburton Place, Room 1109 Boston, MA 02108 CHARLES D. BAKER Tel: (617) 573-1600 Governor Fax: (627) 573-1891 www.mass.gov/eohhs KARYN E. POLITO Lieutenant Governor MARYLOU SUDDERS Secretary Administrative Bulletin 17-01 114.1 CMR 41.00: Rates of Payment for Services Provided to Industrial Accident Patients by Hospitals Effective January 1, 2017 Publication of Payment on Account Factors (PAFs) for Hospital Services The Executive Office of Health and Human Services (EOHHS), pursuant to 114.1 CMR 41.05(1) and (3), is publishing the Payment on Account Factors (PAF) for acute and non-acute hospital services rendered to industrial accident patients. The application of the PAF to all billed charges payable pursuant to 114.1 CMR 41.00 results in the payment of the average percentage of charges paid by the private sector to each hospital for its services and shall be deemed to meet the test of reasonable cost of medical services prescribed by M.G.L. c. 152, the Workers’ Compensation Act. No lesser amount shall be paid unless agreed to by the provider, insurer, and employer. Provided below are the PAFs for acute and non-acute hospital services rendered on or after January 1, 2017. Acute Hospitals PAF % Anna Jaques Hospital 55.42% Athol Memorial Hospital 35.62% Baystate Franklin Medical Center 51.90% Baystate Mary Lane Hospital 50.36% Baystate Medical Center 57.98% Baystate Wing Hospital 43.07% Berkshire Medical Center 66.85% Beth Israel Deaconess Hospital - Milton -
Atrius Health 2019 Participating Providers by Tier
Atrius Health 2019 Participating Providers by Tier Atrius Health St. Vincent Hospital Exeter Hospital Miriam Hospital Ambulatory Surgery and Laser Center Winchester Hospital Franklin Regional Hospital Newport Hospital of Cape Cod Frisbie Memorial Hospital Rhode Island Hospital (including Non-Preferred hospitals Huggins Hospital Hasbro Children’s Hospital) Boston Endoscopy Center (ONLY AVAILABLE ON CHOICE POS) Boston Eye Surgery & Laser Center – Lakes Region General Hospital Roger Williams Medical Center West Massachusetts Littleton Regional Hospital South County Hospital St. Joseph’s Hospital Boston Eye Surgery and Athol Memorial Hospital Mary Hitchcock Memorial Hospital Westerly Hospital Laser Center, Inc. Baystate Franklin Medical Center Monadnock Community Hospital Women and Infants Hospital Boston Out-Patient Surgical Suites Baystate Medical Center New London Hospital Cape Cod Eye Surgery and Parkland Medical Center Baystate Noble Hospital Vermont Laser Center Baystate Wing Hospital Portsmouth Regional Hospital Cataract & Laser Center, Inc. Brattleboro Memorial Hospital Berkshire Medical Center Southern NH Medical Center Charles River Endoscopy, LLC Central Vermont Medical Center Boston Medical Center Speare Memorial Hospital Dedham Medical Associates Gifford Medical Center Brigham and Women’s Hospital St. Joseph Hospital East Pond Enterprises, Inc. Grace Cottage Hospital Brockton Hospital, Inc. The Cheshire Medical Center Eastern Massachusetts Mt. Ascutney Hospital Cape Cod Hospital The Memorial Hospital Surgery Center, LLC and Health