Briefcase

Decision Reduces Electric Transmission Profits, Benefits Consumers
LUDLOW — New England electricity consumers will get a roughly $60 million refund and pay less for transmission service in the future due to a federal ruling reducing the profit that power-grid owners are allowed to earn on their investments. The Massachusetts portion of the refund is expected to be about $28 million, with Massachusetts municipal utilities receiving a refund of approximately $4 million. The decision by the Federal Energy Regulatory Commission (FERC) reduces the allowed rate of return on equity (ROE) for transmission owners from 11.14% to 10.57%. In a 2011 complaint to the FERC spearheaded by the Massachusetts Attorney General’s Office, the Massachusetts Municipal Wholesale Electric Company (MMWEC) and others claimed the 11.14% profit margin was too high, given changes in economic conditions and interest rates since 2006, when the ROE was established. Utility regulators and consumer advocates from throughout New England, as well as U.S. Sen. Edward Markey, also supported the complaint. The Oct. 16 FERC decision found the higher rate to be “unjust and unreasonable,” set the new rate at 10.57%, and ordered refunds of overpayments for the period from October 2011 through December 2012. Litigation is continuing at the FERC to secure additional refunds. “This is an important and positive decision for all New England consumers, and it’s gratifying to see these years of effort coming to a close with a large net benefit for our customers,” said MMWEC CEO Ronald DeCurzio. “We are pursuing additional refunds of overpayments made in 2013 and 2014 and will continue our work to ensure that transmission investments are justified and beneficial to consumers.” DeCurzio said the refunds certainly are welcome, but the benefit increases as the lower rate of return is applied in years ahead to long-term transmission investments. The current $7 billion invested in New England transmission facilities is expected to increase to $11 billion by 2017, and the costs avoided with a lower rate of return will increase as the transmission investment base grows. The FERC has ordered New England’s transmission owners to file a refund report within 45 days of the Oct. 16 order. The transmission companies include National Grid, Northeast Utilities, NStar, Unitil, and Fitchburg Gas & Electric. MMWEC, a nonprofit, public corporation and political subdivision of the Commonwealth of Massachusetts, is the joint action agency for public power in Massachusetts, providing a variety of power-supply, financial, risk-management, and other services to the state’s consumer-owned, municipal utilities.

Massachusetts Employment Numbers Up 9,400 in September
BOSTON — The Executive Office of Labor and Workforce Development reported that preliminary estimates from the Bureau of Labor Statistics (BLS) show Massachusetts added 9,400 jobs in September, for a total preliminary estimate of 3,425,000. The September total unemployment rate was 6.0%, up 0.2% over the August rate. Since September 2013, Massachusetts has added a net of 64,100 jobs, with 62,000 jobs added in the private sector. The total unemployment rate for the year is down 1.2% from the September 2013 rate of 7.2%. BLS also revised its August job estimates to a 4,900-job loss from the 5,300-loss previously reported for the month.

Construction Employment Increases in 39 States
WASHINGTON, D.C.­ — Construction firms added jobs in 39 states between September 2013 and September 2014 while construction employment increased in 34 states and the District of Columbia between August and September, according to an analysis of Labor Department data by Associated General Contractors of America. Association officials noted that the construction job gains come as more construction firms report having a hard time finding qualified workers to fill key positions. “Construction firms in most states have been expanding during the past year,” said Ken Simonson, the association’s chief economist. “But as those firms expand, they have to work harder to attract their skilled craft workers and key construction professionals.” Florida added the most construction jobs of any state (41,900 jobs, 11.2%). Ten states shed construction jobs during the past 12 months, with construction employment unchanged in D.C. and New Mexico. Association officials said the new employment figures show that the industry continues to add new workers after its years-long downturn. But they cautioned that more and more firms are reporting labor shortages. “Hard as it is to imagine, given what this industry has been through the past few years, but many firms are very worried about their ability to find, recruit, and retain qualified workers as the industry continues to rebound,” said Stephen Sandherr, the association’s CEO.

MMS Urges Adoption of Regulations Governing Licensure, Health IT
WALTHAM — The Mass. Medical Society recently urged the state Board of Registration in Medicine (BRM) to adopt a set of proposed regulations that would satisfy a statutory requirement that physicians demonstrate proficiency in health information technology as a condition of maintaining their license to practice medicine. Testifying before the BRM, society Vice President Dr. James Gessner said the requirement is a provision of Chapter 224, the state health-reform law on cost control and quality enacted in August 2012. Chapter 224 required the BRM to establish as a condition of licensure regulations that physicians “demonstrate proficiency in the use of computerized physician order entry, e-prescribing, electronic health records, and other forms of health-information technology, as determined by the board.” The law further specified that, to demonstrate such proficiency, physicians must establish the skills to comply with federal meaningful-use requirements for health information technology. The requirement takes effect Jan. 1, 2015. According to the Massachusetts eHealth Institute, however, only 15,000 physicians who practice in the state have met or are expected to meet federal meaningful-use requirements. The state currently licenses more than 40,000 physicians. “Most of the remaining physicians are, under the law, ineligible for meaningful-use incentives and could lose their license if this statute were interpreted to require meaningful use as a standard for licensure,” said Gessner, adding that this situation would severely affect patient access to care across the Commonwealth, as physicians are prohibited from practicing medicine without a license. “The board has been left to interpret this statutory requirement on its own in a logical manner that is productive and serves the interests of the public. The Massachusetts Medical Society strongly supports the proposed regulatory approach the board has taken in compiling a thoughtful way to implement this requirement.” Among the BRM’s proposals are a provision that applicants may demonstrate skills through their employment with, credentialing by, or contractual agreements with an eligible hospital or critical-access hospital with a federally certified meaningful-use program; by being either a participant or authorized user in the Massachusetts Health Information Highway; or by completing three hours of continuing medical education in electronic records and meaningful use. The BRM also proposed several exemptions from the requirement, including those not engaged in the practice of medicine, such as researchers; medical residents and interns who are experienced with electronic records; those holding an administrative license and not engaged in direct patient care; those with a volunteer license, as these physicians often provide care to the most vulnerable and needy patients; and those on active military duty called into service during a national emergency. Another provision has been proposed to allow physicians coming to Massachusetts who have never been exposed to such a requirement to have the opportunity to be licensed and complete the requirement either through their employment site or other categories after arrival. Gessner, while indicating that large numbers of physicians will be able to comply with the statutory requirement by participating in one of the proposed categories, also cautioned BRM members that, “should any of these categories be eliminated or substantially changed, the impact would be profound on physicians, patients, and the board itself to process such denials of licensure.”

Regional Children’s Hospitals Begin Clinical Collaboration 
 
SPRINGFIELD — Baystate Children’s Hospital and Connecticut Children’s Medical Center have launched a new collaboration addressing potential ways to improve access to high-quality and high-value healthcare for children in Western Mass. and Connecticut. The two organizations, which both provide high-level inpatient pediatric and neonatal care as well as comprehensive outpatient services for children and adolescents, will work together to determine whether they can increase the availability, sophistication, and coordination of pediatric services throughout the Connecticut River Valley, and collaborate with community pediatric providers to improve the overall health and wellness of children in the region. Both have been recognized by U.S. News and World Report among the top U.S. children’s hospitals. “We recognize that an opportunity exists to bring together the talent, vision, and expertise of some of the leading healthcare providers in Western and Southern New England,” said Dr. Fernando Ferrer, chief physician executive at Connecticut Children’s Medical Center. “As the pediatric healthcare environment becomes more complex, the responsible approach is to consider what is in the best interests of our children and families. We are committed to working together with this in mind.” Added Dr. John Schreiber, chief physician executive of Baystate Health, “our two organizations have a lot in common: similar cultures of placing the patient at the very center of our focus and strong commitments to the health of our communities in the broadest sense. In these common traits, we see the foundations of a very successful collaboration.” Examples of areas where both organizations agree that a collaborative approach could improve access and quality of care include pediatric neurosurgery, ophthalmology, pulmonology, and urology, all areas where current provider shortages can make getting care difficult for patients and families. The proposed collaboration may extend beyond clinical-care delivery as the organizations will also jointly explore the potential for expansion of a new pediatric accountable-care organization (ACO) that is now being developed in Western Mass. by Baycare Health Partners, Baystate’s affiliated physician-hospital organization. The goal of an expanded children’s ACO will be to improve the coordination of care between pediatric primary-care providers, specialists, and hospitals throughout the Connecticut River Valley; support the continuing development and implementation of healthcare-quality measures specific to caring for children; and continue the paradigm shift in the provision of care, from treating children when they’re sick to focusing on keeping them well. Another area of potential will be developing research collaborations between the organizations in order to expedite discovery and treatment of pediatric conditions. Both facilities are Children’s Miracle Network hospitals.