By JudyAnn Bigby
Massachusetts Secretary of Health and Human Services
Lawmakers in Washington are still working on a national model for health care reform. Massachusetts is focused on continuing the successes of health care reform and on the next phase of reform that will bend the curve in the rate of health care spending growth. Left unchecked, health care spending in Massachusetts is projected to nearly double to $123 billion in 2020. By contrast, if we can hold our spending to the rate of growth in the state’s GDP, spending would be $107 billion by 2020. In order to achieve the state’s Health Care Quality and Cost Council (HCQCC) goal of moderating health care spending increases to no more than the rate of growth of the GDP spending needs to decrease by a total 7% between 2010 and 2020.
Earlier this month, researchers from the RAND Corporation, an independent policy research organization, presented a policy brief, Controlling Health Care Spending in Massachusetts, to the HCQCC. The state’s Division of Health Care Finance and Policy commissioned RAND to develop a menu of potential cost containment strategies after consultation with the HCQCC and other Massachusetts stakeholders.
The report, which is unique to Massachusetts, provides analysis of 12 possible interventions that the researchers conclude have the most promise to cut spending in Massachusetts out of more than 75 broad approaches considered. Read more…
Lost amid the recent news of changes underway at Cambridge Health Alliance was a more important discussion about the long-term sustainability of our public hospital system and how governments can partner with health care institutions to safeguard critical medical access to those most in need.
While it is human nature to focus on what is lost during times of great change, behind the ambitious plan to reconfigure Cambridge Health Alliance is a broad collaborative strategy and story of self-determination that needs to be further explored.
Cambridge Health Alliance plays an important role in our region’s health care system by providing quality services, particularly to low-income residents. It is a safety-net hospital in the truest sense. For months, the Patrick Administration and the hospital have been working together to develop a shared understanding of the essential health care services to the diverse communities Cambridge Health Alliance serves, the limits of our resources, and how we can work together to ensure the hospital system’s future.
The comprehensive reconfiguration recently approved by the CHA Board of Trustees last month reflects a thoughtful, clinically-driven approach to preserving health care access and quality for its patients and communities given the need to respond to today’s financial challenges. Read more…
America’s medical schools may be among the few winners from the current economic downtown. When the jobs on Wall Street dry up, we can expect would-be investment bankers to flock to medical school. This may be good news, particularly with recent media attention on the Massachusetts Medical Society report predicting that the doctor shortage will only get worse over time.
There are a broad range of opinions about whether the doctor shortage is as described, and how to solve complaints about health care access. The Association of American Medical Colleges has called on medical schools to increase their enrollment by 30%. They have also urged Medicare to lift the cap on Graduate Medical Education funding to support expansion of the workforce. This will be very expensive and may not actually solve the shortage.
More doctors doesn’t necessarily mean better access to care. Adding more dermatologists may decrease the waiting time for botulinum toxin treatments from eight days to six but have no impact on the nearly 30-day wait period to have a changing mole examined. And adding more cardiologists may lead to more angioplasties without decreasing the wait time for consultations for managing individuals with congestive heart failure.
The regional supply of physicians varies widely. Read more…
Over the past two weeks, health care reform in Massachusetts received two powerful shots in the arm. The state’s Division of Health Care Finance and Policy (HCFP) recently announced that 439,000 people have enrolled in health insurance since reform, with 191,000 of those enrolling in private coverage. And, yesterday, the U.S. Census Bureau issued a report showing that the national rate of uninsurance decreased, with Massachusetts having the lowest rate of all states.
There’s more good news. HCFP’s quarterly Key Indicators also reported that care for the state’s remaining uninsured financed by the Health Safety Net – formerly known as the Uncompensated Care Pool – has decreased markedly as insurance enrollment has increased. In the first quarter of the Health Safety Net FY08, there was a 37% decrease in the number of patients using the Health Safety Net in community health centers and hospitals, compared to the same time period last year.
These newest numbers demonstrate that health care reform is working, thanks to diverse efforts to insure people — including the expansion of Medicaid, publicly subsidized insurance and the individual mandate. A diverse group of stakeholders have worked together to make these achievements possible, but we still have work to do to make sure that our progress is sustainable going forward.
Consumers, employers and government must all do their part to get Massachusetts to near-universal coverage. The overwhelming majority of employers in Massachusetts are doing the right thing, with 72% of employers offering health insurance to their employees in 2007.
There is still a small minority of employers who are not covering their employees. 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…
Last week, the Massachusetts Health Care Quality and Cost Council (HCQCC) issued its first Annual Report, which identifies specific strategies for providers, insurers, employers and consumers that are designed to improve health care quality while containing costs. The Council’s recommendations address a range of issues that have long been acknowledged as needing attention to improve patient safety and the quality of care while at the same time decreasing inefficiencies and unnecessary costs in the system. The Council’s recommendations are unique in that they reflect discussion and collaboration among a wide range of stakeholders and represent hundreds of hours of work by individuals Council members.
These recommendations reflect the overarching goals set by the Council last year. We are committed to reducing the annual rise of health care costs to no more than the unadjusted growth in Gross Domestic Product by 2012; Read more…
Just over a month ago, Governor Patrick unveiled his budget for Fiscal Year 2009, which makes targeted investments in health care reform and primary care initiatives, as well as education; public safety; job creation; and partnerships with cities and towns.
Health care reform will not succeed with insurance reforms alone, and investing in health care reform and primary care are key priorities for the Patrick Administration. We must promote policies that ensure that people have the right care in the right place. Massachusetts must receive the best value from health care expenditures, while ensuring health care is safe, timely, efficient, effective, equitable and patient-centered.
We continue to support the goal of near-universal coverage, and the first year of this innovative program has been a success. More than 300,000 people who were uninsured now have health coverage. Yet even beyond continuing to support expanded coverage through Commonwealth Care and MassHealth, there is other important work to do. We need to focus more attention on health care costs and improved access to primary care services for all people in Massachusetts. Several initiatives in the Governor’s budget reflect these goals. Read more…
Last month, the Patrick Administration launched HealthyMass, an historic health initiative designed to make Massachusetts a healthier place to live and work. Nine agencies from across state government—in their roles as employers, purchasers, providers, regulators, insurers, administrators, stewards of public health, and potential sources of health care financing—committed to collaborating to achieve five goals that reflect the values and principles of the Patrick Administration.
By aligning policies and practices, these agencies will work together to ensure access to care; contain health care costs; advance health care quality; promote individual wellness; and develop healthy communities. Collaboration is the key to success, and working together with those in state government—as well as other key stakeholders—will be essential. Early on in our work, we will decrease administrative burdens on providers; adopt strategies to improve quality of care; focus on decreasing the impacts of chronic disease; and align payments to support primary care and community hospitals.
Pay for performance initiatives are increasingly recognized as a strategy for improving health care quality, and many payers have adopted this strategy. Read more…
Massachusetts’ health care reform means that more than 300,000 people in Massachusetts have signed up for health insurance in the past year and no longer have to fear getting sick or waiting until they are severely ill before they seek care. By all measures, this is good news, and ongoing outreach and enrollment efforts are moving the Commonwealth closer toward universal coverage.
As more and more individuals acquire insurance, we must recognize that insurance does not ensure access. Having a regular provider and a regular place to go for health care is necessary to ensure that people get the right care in the right place.
The demand for primary care providers in Massachusetts is on a lot of people’s minds. Anecdotally, people relate that primary care providers are a scarcity, that wait times to see a provider are often unacceptably long and that too many providers are not taking new patients.
Despite one of the highest physician to population ratios in the country, a smaller percentage of physicians in Massachusetts practice primary care. There are simply not enough providers to meet Massachusetts’ evolving health care needs, given the increasing enrollment in managed care plans. Read more…
IF YOU ARE WHITE AND WELL EDUCATED IN MASSACHUSETTS…YOUR HEALTH IS GENERALLY GOOD…ACCORDING TO A STATE REPORT OUT TODAY. BUT IF YOU DIDN’T GRADUATE FROM COLLEGE…YOU DIE YOUNGER THAN RESIDENTS WHO DID. AND IF YOU ARE BLACK OR LATINO…YOU FACE MORE HEALTH PROBLEMS IN JUST ABOUT EVERY CATEGORY, ON AVERAGE, AS COMPARED TO WHITES. JOINING US FOR A LOOK AT WHO’S HEALTHY, WHO’S NOT AND WHY, IS SECRETARY OF HEALTH AND HUMAN SERVICES, JUDYANN BIGBY.