We live in an age of online consumer reviews for nearly everything – restaurants, televisions, contractors, CDs – even doctors and hospitals. In fact, if you conduct a Web search of “doctor reviews Boston,” a half dozen options pop up, including ads with headlines like: “Is your doctor good?” and “Avoid these doctors.”
Coming from an organization that was one of the first to measure patients’ experiences with their health care, I can hardly argue against the value of consumers’ opinions about their doctors, but we need to be cautious when “ratings” are based on a handful of patients who are either angry enough or happy enough to register their views online, with most doctors receiving no comments at all. This kind of feedback can lead consumers to false conclusions about the care being provided, and it is certainly not useful to physicians who want to find ways to strengthen their relationships with patients.
Visitors to the Massachusetts Health Quality Partners website get a much different view of how patients assess their care. You won’t find any comments about individual doctors, but you will find a simple tool that allows you to examine 400 primary care practices in Massachusetts through the eyes of other consumers, based on a comprehensive survey of 51,000 adult patients and 20,000 parents of pediatric patients. New data from the resulting report, Quality Insights: Patient Experiences in Primary Care, was posted today. Read more…
If there was one thing that struck both observers of, and participants in, the creation of the Massachusetts health care reform law, it was how many seemingly diverse groups came together to make the unwieldy law work. Yes, there were disputes – and they continue today. That can be expected from a law that affects literally everyone in the Commonwealth. But in general, hospitals, insurers, physicians, regulators, consumers, religious groups, and others united and have remained together – a rarity in any state, but especially so in our often fractious Commonwealth.
Now that the reform law is well on its way of achieving its main goal – insuring the uninsured – its remaining challenge of lowering health care costs will require the same sort of collaboration. I’m happy to report that this May, the hospital community, under the leadership of the Massachusetts Hospital Association, brought together 80 key individuals to discuss diabetes management – a big cost center in our state’s health care system.
It was called a “charette” – an architectural word referring to brainstorming to develop solutions to a design problem within a limited timeframe. Read more…
On July 1, Commonwealth Care members started paying the higher premiums and co-payments approved in April by the Connector board (of which I am a member).
At the time these increases were approved, there were assurances that this was just the first stage of increased “shared responsibility.” We were told that while consumers, and particularly those with low and moderate incomes, were the first to be asked to do more, employers, health insurers and providers would soon follow in order to help address the financing challenges of health reform.
Well, it’s three months later….and we’re still waiting for any new responsibilities to be imposed on employers, providers and health plans. I hope we’ll see some action soon since time is running out in this legislative session. But lest I criticize others for inaction when I am guilty myself, I admit that I never produced the update on health plan financial results for year-end 2007 that I mentioned on this blog back in February. I thought I’d link the two issues of health plan financial results and shared responsibility, just in case anyone is having trouble thinking of ways that health plans could be asked to do more for health reform. So, I’ve put together some health plan financial numbers for 2007, ranked in order of how many Commonwealth Care members could be covered for the same amount of money. Read more…
Babies born to Black mothers die at 4x the rate of White infants in the first year of life. Boston Public Health Commission director Barbara Ferrer says racism is the main factor. She explains her reasoning in the slide show below.
This presentation was produced by Molly Feit and Jesse Costa.
There’s more on the topic in this article from EthnicNewz.
(Click here for more reports on the cost of mandated benefits, updated 7-30-08)
A bill that would increase mandatory insurance coverage for mental health issues is pitting consumer advocates against insurers and business groups worried about rising premium costs. Here’s a description of the change:
“Under the Commonwealth’s current law, benefit parity exists for nine “biologically-based” mental health conditions for adults and for any conditions in children (18 and under) that limit functioning and social interaction. Conditions specified under this law are covered without annual or lifetime benefit limits and are also at parity with regard to cost sharing. Other conditions not included in these requirements must be covered for at least 60 inpatient days and 24 outpatient visits. Currently, benefits for alcoholism and chemical dependency are mandated to include 30 days of inpatient treatment and $500 for outpatient treatment. H. 4423 extends this partial parity to full parity for both mental health and substance abuse services, requiring non-discriminatory coverage for the diagnosis and medically necessary treatment of mental health and substance abuse disorders as described in the most recent edition of the Diagnostic and Statistical Manual (DSM) of Mental Disorders.”
That description is in a report out today on the cost and other impacts of the bill. Here’s a summary of the findings:
“The projected increase in spending that would result from H. 4322 ranges from 0.1% to 0.3% of premiums or $12.9 to $38.8 million. The per member per month (PMPM) impact ranges from $0.46 to $1.39.”
Worth it? Read more…
As “CommonHealth” blog readers have surely been following in the news, Governor Patrick and I traveled to Washington to meet with key Bush Administration officials about our Medicaid waiver renewal application.
Extending the state and federal partnership embodied in Massachusetts’ Medicaid waiver is critical to our historic effort to reach near universal health insurance coverage.
Why should the federal government support our waiver renewal?
Evidence of the successes of health care reform continues to come in. The 1115 Medicaid Demonstration Waiver has helped us dramatically reduce the number of working-age adults in Massachusetts who are uninsured. Not only are more people insured, but we have seen an expansion in access to health care. Primary and preventive care are on the rise as we continue to implement health care reform. More low-income adults report having a primary care provider and fewer have unmet health care needs.
The Medicaid Waiver is a large part of the success. Read more…
A flu pandemic and disaster preparation plan that has languished for more than two years is finally moving at the State House. The bill gives the Department of Public Health new authority to direct state resources and personnel and quarantine areas or people. It provides liability protection for medical staff that might be required to work in nontraditional settings. Department of Public Health Commissioner John Auerbach says although bird flu outbreaks, for example, are not in the daily news, the state must be prepared.
All indications are that we will have a serious influenza epidemic in the coming years and part of our responsibility is to plan for possible emergencies even if they are emergencies that are not likely to occur for many, many years.
The bill does not provide funding for additional hospital beds, medical supplies or medications, but asks for a report on funding needs by years’ end. Massachusetts has begun stockpiling anti-virals.
The bill cleared the Senate today. A House sponsor says he expects a similar version will pass in that chamber.
Sermo, the online professional/social networking service for physicians, aims to become an organizing site for physicians dissatisfied with the way they practice health care. Sermo is out with this press release about it’s “Open letter from American Physicians.” The letter describes frustrations with health insurers, regulation and medical malpractice laws. Sermo says the next step will be asking doctors for solutions the company hopes to raise during the presidential campaign.
Senate President Therese Murray called leaders of the Massachusetts Hospital Association and the Massachusetts Nurses Association to her office yesterday to say that the Senate will vote soon on nurse staffing legislation that has cleared the House. The bill would give the Department of Public Health the authority to set nurse to patient staffing ratios. Murray, according to 2 people at the meeting, told both sides that the bill may come up on short notice and offered the opportunity to discuss common ground. She did not suggest any compromise language or say whether she thinks the controversial measure will pass. Aides to Governor Deval Patrick have said they hope the bill does not reach his desk.