In advance of President Obama’s health care summit on Thursday, here’s the latest organizing effort by the nonprofit, Health Care For All of Massachusetts:

On Monday, Health Care For All helped bring together a broad wall-to-wall spectrum of community leaders to send a singular message loud and clear to Washington: National Health Reform is Good For Massachusetts. The speakers represented consumers, labor, religious communities, immigrants, insurers, business leaders, state government, hospitals and physicians.

Why is national health reform good for Massachusetts? Here are excerpts of some of the key points made by the speakers at Monday’s forum:

Expands Coverage: “Health Care For All is committed to national health reform because it will make health care more affordable to more than 75,000 Massachusetts families who are struggling to meet their basic needs.” – Amy Whitcomb Slemmer, Executive Director, Health Care For All

Helps Small Business: “An estimated 70,000 small firms would benefit in Massachusetts, and our economy and health would be improved. That’s why national health reform is good for Massachusetts.” – Phil Edmundson, CEO, William Gallagher Associates

Helps Seniors with Drug Costs: “National health reform is good for Massachusetts seniors. It will protect guaranteed Medicare benefits, and it will also close the Medicare prescription drug coverage gap. That gap alone threatens 300,000 seniors every year with an additional $3,600 in out-of-pocket costs.” – Deborah Banda, State Director, AARP Massachusetts

Helps Working Families: “Health reform has been good for Massachusetts workers, whether you are part-time, whether you are temporary, whether you are between jobs. If national reform happens, we will be able to help more middle class working families. It is good that Massachusetts has done what we’ve done, but it will be better when national reform happens, because more of us will be protected. – Celia Wcislo, Vice President, 1199SEIU

Expands Jobs for Massachusetts: “National health care reform would play to Massachusetts’ strengths. It would fuel our jobs engine and our international leadership in medicine, and make the greatest workforce in the world – the people of Massachusetts – even more productive.” – Jay Gonzalez, Secretary, Executive Office of Administration and Finance

Strengthens Hospitals: “Washington can help us cut through the red tape so our hospitals can be more efficient. Washington can mend the health care safety net that hospitals struggle to bind. We can help build information networks for hospitals to improve the quality of care. It’s late, but it’s not too late for Washington to do its job, so we can do ours.” – Tim Gens, Senior Vice President, Massachusetts Hospital Association

Supports State Budgets: “It’s no secret that the reimbursements from the federal government help fund health reform. National health reform will be important in its own right, and it will also be important for Massachusetts in terms of funding on a long term basis.” – Mike Widmer, President, Massachusetts Taxpayers Foundation

Controls Health Costs: “We need national reform. It is a moral issue that we get cost containment, and we won’t get there unless we close the exit to health insurance.”– Jon Kingsdale, Executive Director, Commonwealth Health Insurance Connector Authority

Facilitates Hospitals Care for the Uninsured: “As a physician, I can see each and every day the great good that health reform in Massachusetts does for our patients and their families – at the Mass General, the Brigham, North Shore Medical Center, places that have taken care of previously uninsured people. National health care reform is necessary to bring this greater good to all those in great need.” – Gary Gottlieb, President and CEO of Partners Health Care Read more…

April Seligman & Georgia Maheras, of the advocacy group Health Care For All, explore various ways to deal with problems that arise from patient “transitions,” between health care facilities and from unnecessary hospital readmissions:

Last week, the Health Care Quality and Cost Council met to discuss a new initiative aimed at keeping patients healthy and out of the hospital. The plan is focused on improving “transitions to care” and preventing repeated and unnecessary hospital stays.

Care transitions are when a patient is transferred from the hospital to a rehabilitation center, is moved from a nursing home to a hospital, or is readmitted to the hospital for something that could have possibly been prevented.

Massachusetts has a disproportionately high rate of hospital readmissions compared to other states. This new initiative is designed to improve post-discharge communication and coordination and reduce this rate.

At the HCQCC meeting, Alice Bonner PhD, RN from DPH, Craig Schneider from the Massachusetts Health Data Consortium and Dr. Joel Weissman from EOHHS identified barriers to effective care transitions; they are both structural and procedural and include a lack of integrated care and effective communication. Under use of clear performance measurers to indicate optimal transitions is also problematic. The result of these barriers is that patients are in the hospital repeatedly and unnecessarily.

Care transitions present a unique opportunity to improve the quality of health care for patients in Massachusetts. It should also result in cost savings as well. It is the opportunity to provide better care for all Massachusetts’ residents. The goal of this care transitions strategic plan is to have interdisciplinary teams delivering safe, effective, and timely care that is culturally and linguistically appropriate in various types of settings. Furthermore, there must be an alignment of clinical care, public health, and health policy. Read more…

Georgia J. Maheras, Esq., Private Market Policy Manager, Health Care For All, envisions a health care system that focuses on patient care:

During this magical time of year, festivals of lights illuminate homes, visions of sugar plums dance in children’s heads, and the promise of a new year fills us with hope and optimism. Now is the time to invite you to journey with us to a special place; a place where health care is patient-centered.

In our utopia, our patient, Jasmine, can spend more time with her doctor to really discuss her care instead of the typical 15 minute visit she has now. She would have chosen her doctor after thoroughly comparing quality measures about providers that were easily accessible, because this critical information is available to all patients.

Jasmine’s interactions with her primary care team would focus on preventive care and wellness. If Jasmine did become ill, her primary care team would fully coordinate her care and provide a level of transparency that would allow her to be deeply engaged and make well informed decisions about her care. Her medical records would be freely accessible to her and the members of her care team. This readily available information would unburden the process and stave off duplicate testing and miscommunications.

In this patient-centered health care system, Jasmine would not have to pay co-pays for wellness visits, chronic illness visits, or medications for her chronic illness. She would be able to reach a provider or clinician after hours or on the weekends and have her questions answered. After all, Jasmine doesn’t just get sick from 9 to 5. Read more…

Christine Keeves, MPH, and the Oral Health Communications Coordinator at non-profit Health Care For All, says state budget cuts could mean no more critical oral health care for some of the state’s most vulnerable residents:

In recent years, Massachusetts has led the nation by creating a new system to address our state’s health care needs. As we are increasingly used as a model for improving health care throughout the country, we must ensure that we protect some of the most critical pieces of this system, including oral health care.

With access to simple, cost-effective preventive care, we can keep our state and our nation healthy. Protecting these benefits is imperative for several reasons:
· Oral health is an essential part of overall health. Chronic oral infections are associated with complex health problems such as heart disease, stroke, diabetes, low-birth weight, and premature infant births.
· Lack of preventive care causes the state to waste millions in extensive and costly services in emergency and inpatient hospital settings.
· Lack of comprehensive and consistent dental care prohibits many adults form entering or remaining in the workforce. Currently, 164 million hours of work are lost in US each year due to dental disease.

By law, the governor must balance the state budget, and on Thursday announced a $600 million deficit. Currently, Governor Patrick can only make up these deficits by cutting from certain types of programs, including public health. Read more…

Last week the American Board of Internal Medicine Foundation convened a four-day meeting on physician payment reform. The title of the gathering was “Achieving Equity, Affordability and Quality, The Indispensible Role of Payment Reform” and it attracted an esteemed group of experts, medical professionals, academicians, consumers and payers. The goal for this forum was to establish a guiding set of principals for national payment reform.

Early in the meeting speakers identified competing pressures that will challenge the adoption of a different payment system. Speakers and meeting participants spoke of the need to maintain patient centered care, patient and doctor autonomy, while being mindful of limited resources in the face of unlimited need. There was near unanimous agreement that most physicians don’t actually know what things cost, and some very funny anecdotes about trying to find out cost information. (One doc asked a lab manager what a panel of tests cost only to be told that the manager was prohibited from sharing that info. When pushed, the manager suggested that the doc couldn’t handle the truth.)

Dr. Harvey Fineberg, the President of the Institute of Medicine gave the keynote address and opened his remarks by polling the physicians in the room about how they are paid. Read more…

As we look back over our shoulders at national health reform proposals, which continue to draw from the Massachusetts experience, we also continue to look ahead at improving Massachusetts health reform.

This week, for example, the legislature will be hearing a number of bills to strengthen both the quality and access threads of health reform.

On Tuesday, the Public Health Committee will be hearing three bills drafted by HCFA’s Consumer Health Care Quality Council. The Council gives a voice to people impacted by poor quality medical care. They have joined together to work for real improvements in our system. The bills are:

• An Act to Improve the Delivery of Healthcare (S. 878/H. 213), filed by Sen. Moore and Rep. Provost, directs the use of checklists in hospital procedures. The bill would reduce medical errors and infections in hospitals by requiring that a series of safety steps be explicitly checked off by healthcare providers to decrease patient harm for given procedures. Airline pilots always run through their checklist before takeoff, and when surgeons do it, death and complication rates reduce dramatically.

• An Act to Reduce Healthcare-Associated Infections (H. 2139), filed by Rep. Provost, calls for screenings of high risk individuals entering a hospital setting for the “superbug” MRSA, a highly-infectious bacteria that’s resistant to most anti-biotics. Two years ago, that CDC reported that more people in the US die from MRSA than AIDS. Read more…

The Division of Health Care Finance and Policy (DHCFP) has proposed regulations which would require schools to report more comprehensive information on their health plans’ benefits and performance. The ACT!! Coalition will voice our perspective on these regulations at DHCFP’s public hearing tomorrow. The ACT!! Coalition strongly supports the proposed regulations increasing disclosure and reporting requirements. We appreciate the DHCFP’s commitment to analyzing student health insurance plans and requiring that students are provided with transparent information about their plans. As Massachusetts leads the nation in guaranteeing that our residents have access to quality health insurance coverage, we commend DHFCP for ensuring that students do not fall through the cracks.

ACT!! has significant concerns with student health plans, particularly the lack of comprehensive coverage and unaffordable cost-sharing. The skinniest of the skinny, student health plans often do not cover basic services such as prescription drugs and surgery. Read more…

My name is Hannah Frigand, and I am a HelpLine Counselor at Health Care For All. I started working on the HelpLine as an intern January of 2006, and I began working full-time that fall. When I first started taking calls, it was before Health Reform passed, and we were receiving between 100-150 calls a week in English and Spanish. Currently, we receive over a thousand calls a week in English, Spanish and Portuguese and are looking to expand in even more languages. When I started working at the HelpLine, there were only two full-time counselors; now there are five.

In 2008, the HelpLine took a total of 37,472 calls and completed 1,870 health insurance applications over the phone. Behind each application is an individual or family who we have guided through the health care system. For each one of these clients, we have followed up individually and notified them of the status of their application and their next step. Our callers include those who need help making a doctor’s appointment or getting prescriptions filled at low- or no-cost; those who need assistance with medical debt or appealing a MassHealth decision; and those who have questions about private insurance or need assistance completing an application for the state programs.

The HelpLine calls have increased in the last few months, and we are hearing a lot of new stories from people who have never turned to the state for assistance before. Here are some of the changes:

– So far this month, the call volume has increased by 67% compared to same time-frame last year. Read more…

Last summer, the Massachusetts legislature passed Chapter 305, a comprehensive cost control and transparency bill. As one of its central pillars, the bill directed the Department of Public Health (DPH) to draft regulations establishing a Code of Conduct and payment disclosure requirement for the pharmaceutical and medical device manufacturing industries. This component of the bill is one of the keys to the health care cost control Massachusetts so desperately needs.

Prescription drugs are central to modern health care. Medications are the first line of defense in preventing and combating disease. The prices of the most widely used brand-name prescription drugs rose nearly 50% between 2000 and 2006, more than twice the rate of inflation. Research has shown that gifts and fees paid to prescribers influence their prescribing behavior and cause more brand-name drugs to be prescribed when cheaper, generic drugs are as effective. The billions of dollars spent annually place a huge financial burden on the entire health care system. According the Congressional Budget Office, disclosing industry payments could lead to health cost reductions. Read more…

The economic downturn and resulting decreased revenues have forced Governor Patrick into difficult decisions. The result has been significant, and often dramatic, cuts to state health programs – even those designed to serve individuals and families in the most need.

Across the country, other states are similarly feeling the pinch, and Congress has been considering options to help. One potential opportunity to lessen the impact of budget cuts on the health care system is a short-term increase in the Federal Medical Assistance Percentage, or FMAP. FMAP is the percentage that the federal government reimburses to the states for Medicaid expenses. Because Massachusetts is one of the richer states, we receive the minimum – 50%. Read more…