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. Providers are clamoring for coordination of performance measures across payers, so that they do not waste time and resources capturing and measuring unique outcomes for every payer. Collectively, the GIC, Commonwealth Connector and MassHealth cover more than 1.6 million people in the Commonwealth and contract with many of the same providers. One of our initial HealthyMass strategies will coordinate and align performance measures and incentives across these state agencies. Aligning our policies will amplify the impact on quality of care and simplify the processes for providers who must meet the performance standards.
We will also improve efficiencies and reduce the burden on and expense to providers by consolidating the processes through which they submit common data to different state agencies. By streamlining administrative functions, the state will also gain greater flexibility and efficiency in accessing and using the data.
According to an October report from the Milken Institute, Massachusetts ranks 40th in the nation in its burden of chronic disease, which negatively impacts the state’s economy because of associated health care costs and the health of our workforce. Through the HealthyMass initiative, state agencies will work together and with partners in the private and nonprofit sectors to develop a coordinated approach to prevention and management of chronic diseases – starting with obesity and diabetes. This effort will focus on individual and community wellness and prevention; the elimination of gaps in early diagnosis of diabetes; coordinated disease management that will reduce the incidence of diabetes across the state (especially within racial and ethnic minority communities); and decrease unnecessary hospitalizations and emergency department visits.
We will also develop alternative payment strategies that prioritize the delivery of high quality, efficient and effective health care, and hold providers accountable for specific outcomes. Reform of the current payment system will allow for better care—rather than just more care—and care in the right place.
The HealthyMass initiative represents a genuine transformation in how we approach health and health care in Massachusetts. Our cross-agency efforts will work towards a more comprehensive approach to health that recognizes the inextricable links between cost, quality, access and prevention and wellness. Our motto is “Our Health is Our Commonwealth.”
JudyAnn Bigby
Secretary for Health and Human Services
Congratulations to these remarkable steps towards improving the health care system! You hardly can find a place where is such a collaboration within the official organs who are dealing with the subject. I had several attempts in our city to improve prevention and wellness which are not as costly issues but I`ve found closed doors. Due to the fact that I`m a Toronto life insurance broker I meet every day with the people`s requirements on the subject. Definitely I`ll try to raise the topic again, I got some inspirations from you. Good luck with your project!
Establishing a formal policy for better coordination of health care in the Commonwealth is both welcome and long overdue. Secretary Bigby should be commended for gaining support across the relevant agencies for these goals and objectives. They are certainly consistent with the goals of a caring Commonwealth and with the legislative intent of Chapter 58. The real test, of course, is for these objectives to be fully and expeditiously implemented in the ongoing practices of the respective agencies, if real savings and improvements in health care quality and safety are to be achieved. The “devil,” as they say, is always in the details!
One important signature, in my opinion, is missing from the compact. Governor Patrick would do well to convert this compact into an Executive Order to give these goals and objectives the true force of law, and to direct the participating agencies to amend or develop regulations consistent with the stated goals and objectives. Other governors have convened health care task forces and issued sweeping policy statements, but they have not resulted in real health care reform. A concerted administration-wide effort to make sure that the goals and objectives of the “HealthyMass Compact” are embedded in the Code of Massachusetts Regulations would produce meaningful results.
In addition to implementing regulations to fully implement the “HealthyMass Compact,” I would hope that the Governor’s budget request for FY ‘09 would provide additional evidence of the Governor’s commitment to the goals and objectives of the “HealthyMass Compact.” Other governors, in the past, have issued proclamations supporting various improvements to our health care system and then cut health budgets or vetoed provisions that turned those proclamations into empty promises. The Patrick-Murray Administration now has an important opportunity to take full ownership of the health reform agenda and move that agenda forward in a dramatic fashion.
The compact presents the Commonwealth with an opportunity, as a major payer of health care services, to lead all payers in:
1) Developing a common set of quality measurement standards through the Quality and Cost Council so that providers are all measured fairly. It makes no sense for the Group Insurance Commission, the Connector, Medicaid, and the private plans to use different measurement tools and different reporting when providers almost always submit payment requests to multiple payers.
2) Developing a common billing code so that one procedure means the same for one payer as another. This could significantly save administrative costs in hospitals, doctors offices, and health centers as well as with the payers, themselves.
3) Promoting transparency in state programs and providing state leadership in electronic health records and other forms of health information technology.
Senate President Murray has already proposed legislation, currently being finalized, that should be strongly supportive of the concepts articulated in the “HealthyMass Compact.” I look forward to a collaborative effort between the Administration and the Legislature in the coming year.
Actually, you have it backwards, Judy: Our Health is Not Your Wealth!
a)The subsidized and unsubsidized insurance is not affordable for many residents. The Connector’s affordability schedule for 2007 – 2008 failed to acknowledge current income in MA due to the lack of viable jobs, not to mention, the increases in the cost of living nearly all people in this country are facing. I doubt the Connector will do any better for 2009 since, due to the lack of any meaningful cost control, the premiums will go up while benefits are slashed.
Furthermore, the Connector did not bother to include copays in their math (Globe article, April 2007) and those who allowed themselves to be intimidated and purchased insurance although they could not afford it, may not be able to access care because they won’t have money to pay the co-pays, coinsurance or deductibles.
b) The “robust” waiver promised by the Connector and the “generous” waiver stipulated by the law itself are non-existent. For those 300% and below FPL, the process to request a hardship appeal and then to actually appeal is draconian – a deep and expensive bureaucratic maze meant to confuse, bewilder and deny.
c) The coverage is not comprehensive and low-to-middle income residents will have a difficult time paying for dental and other non-covered items, not to mention copays which are scheduled to increase while incomes remain stagnant or decrease.
d) All plans are HMOs which are not as interested in patient care as they are in profits for their stockholders. Thus, that fact combined with the fairly recent proclamation by the Connector that. due to the high costs for the state, they will have to “push providers” to limit care for chronic conditions and substance abuse by providing better oversight is a clear indication that care for residents enrolled in Commonwealth Care and Choice is about to take a downward slide from what is already down.
e) There is a serious shortage of doctors in MA and, on top of that, many who will have nothing to do with Commonwealth Care. Those who did sign up to see Commonwealth Care patients will be hard-pressed to continue as the amount paid to them wasn’t enough to cover their overhead and that amount is being decreased because Gruber doesn’t think they should be paid more than Medicaid pays. In fact, there are some real horror stories about patients not being able to find PCPs that will see them, much less, specialists.
e) Increasing penalties to force people to sign up for health insurance truly shows that you and the rest of your crowd, including Deval Patrick, don’t care about the well-being of MA residents. If people cannot afford the premiums, what makes you think they can afford the penalties?
Thus, your goal must be to have people stop heating and eating. Maybe they should move into cardboard boxes in back alleys so they can afford to purchase insurance? As long as you save face. All eyes are on MA and you have so much at stake.
To sum it up, the health care crisis in MA has not been addressed by this law. Mandating that everyone have health insurance does not mean that you have provided health care to all residents. What you have provided for many, however, is either another monthly bill or a tax penalty to add to their stress, and stress is definitely not conducive to good health. So knock it off with the HealthyMass Initiative spin.
It is becoming very obvious to many in this country what is truly going on in MA although you try to spin this as a success. This is a scam that is so far-reaching, it is frightening.
By the way, Barack Obama clearly understands that this is not such a great deal for MA residents and has stated so several times on national TV although not in the same words. How can Deval Patrick even look him in the eye?
Such type of steps should be appreciated. All these agencies will help to improve public health. I think the focus of HealthyMass should be more wide.
Whole heartedly agree with ‘reporter’ comment above. The push for positive spin on this mandated policy where big government knows best and has taken away one more personal choice from us is to make the impression to those who haven’t yet signed to do so, thinking they are in the minority. Unfortunately these are the folks today which the insurance is not being offered to them “free” and must pay at the expense of other needs. This not like car insurance …I choose to drive and therefore choose to buy insurance if I want that privilege ….however, being alive is an inherent right (not a privilege), but I’m being forced to buy insurance nonetheless. Please note that I have had health insurance long before this law but am very bitter and considering to move my family out of MA simply because my freedom of choice has been taken away. Be aware people …what other individual freedoms are you ready to give up for the sake of the whole? Of the 300,000 people signed for insurance who couldn’t afford it, how many of those do you believe could if they made the right choices in their life with the opportunities offered to them here in America? I’m not naive and recognize that there are those who are truly disadvantaged but the old social umbrella assisted them, as it had over the years before. The issue is that the cost of health care today has increased that pool of people needing help more than ever, but the answer is capping/controlling costs charged by the huge health industry and not taking individual liberties away. Let’s get rid of this mandate and let’s start managing these health care and drug manufacturing companies so we can control these costs. Our State government is simply unwilling to take on this task but did not balk at attacking the individual taxpayer.