– More businesses offer health insurance to their employees today than before our 2006 reforms took effect, some 78 percent of Massachusetts businesses as compared to the national average of about 69 percent
– Preventive care is up: more people are receiving cancer screenings, more women are getting pre-natal care and visits to emergency rooms have decreased. 150,000 people have stopped smoking because we expanded coverage for smoking cessation programs. A recent study by the National Bureau of Economic Research documents improvements in physical health, mental health, functional limitations, and joint disorders as a result of increased access to care in Massachusetts. Women, minorities and low-income people have experienced the biggest health improvements.
– Among Hispanic males, a notably underinsured population in Massachusetts before health care reform, the detection of testicular cancer has more than doubled and the majority of cases are now detected at an early stage.
– And with wider access to screenings, we’ve seen a 36 percent decrease in cervical cancer in women.
– Over 90 percent of our residents have a primary care physician, and 4 out of 5 have seen their doctor in the last 12 months.
A sweeping health care cost-containment bill is heading to the desk of Governor Deval Patrick.
“This is more than a good bill, a really great bill,” Patrick said. “This is a commonwealth that has shown the nation how to extend coverage to everybody… and we’re going to crack the code now on cost control.”
The Governor and legislature are celebrating a bill that has broad support but is being received with more wariness and trepidation than recent major health care efforts, including the landmark coverage law. As we’ve heard again and again, tackling health care costs is going to be hard.
Trying to hold down health care costs is one of those third-rail issues that many politicians won’t touch. As he introduced the bill, House lead author Steve Walsh stressed that while it’s projected to saved $200 billion dollars over 15 years, that’s not the only goal.
“What should be important to us is our son or daughter, or our husband or wife, or our mother or father,” Walsh said. “And making sure that the health care that they need, that they deserve, is available to you, your constituents and your families in time of need. And there’s nothing that we have done in any way, shape or form here today that will inhibit that.” Continue reading
WBUR’s Martha Bebinger reports:
I’ve been waiting to hear from Governor Patrick on one of the most controversial health care cost control issues on Beacon Hill: what to do about hospitals that charge three, four or five times more for an MRI (and hundreds of other services) with little or no difference in quality.
Two reports from Attorney General Martha Coakley and at least two from the Governor’s administration (the latest here) say that inflated prices based on the market clout of major teaching hospitals are a major factor driving health care costs in Massachusetts.
Now we have some insight into the Governor’s position on this dicey problem. During a Greater Boston Chamber of Commerce breakfast Tuesday, the Governor was asked whether he wants a provision in the final health care costs bills from the House and Senate that would deal with what’s often called “price disparities” among hospitals? The Governor framed the problem as one of “market clout” and said dealing with the market clout of top Boston hospitals is in the hands of AG Coakley.
The AG, said Patrick, “has tools today to address these imbalances and we have to look to her office to use those tools.”
I called Patrick’s office to clarify. What “tools?” An aide says the Governor was referring, loosely, to the AG’s ability to file anti-trust charges against hospitals. Continue reading
On the 6th anniversary of the signing of the Massachusetts health reform law, Gov. Deval Patrick (who also serves as a co-chairman of President Obama’s re-election campaign) took the opportunity to stick it to the likely GOP presidential nominee in remarks at Fanueuil Hall yesterday, The Wall Street Journal reports. There was even talk by national health law advocates of sending Romney (who signed the state health law on April 12, 2006 when he was governor of Massachusetts) a delicious gift to mark to occasion.
“I think he has a lot to be proud of, he contributed ideas, the individual mandate was one of them…why not be proud?” said Gov. Deval Patrick, a co-chair of President Barack Obama’s national re-election committee, referring to Mr. Romney’s support for the state’s requirement that individuals purchase insurance or pay a fee…
The event underscored how Democrats are trying to turn Mr. Romney’s health-insurance expansion into a political liability as he looks toward the general election. Activists who support the federal health law will delivery grocery-store-bought sheet “birthday” cakes with six candles in honor of the Massachusetts health law to two of Mr. Romney’s campaign stops in Pennsylvania on Thursday, said Eddie Vale, a spokesman for the Protect Your Care coalition of campaigners.
To underscore the politics of the day, here’s video from the folks at BarackObama.com:
For a bit more substance, see The Washington Post’s Wonkblog on “Charts: Six Ways RomneyCare Changed Massachusetts.”
Gov. Deval Patrick has had plenty of practice at painting a positive picture of Massachusetts health reform. But I see a couple of points that feel fresh to me in his speech this morning to the American Cancer Society in Washington, D.C.
He says that Massachusetts health reform has led to significant improvements in cancer screening:
Among Hispanic males, a notably under-insured population in Massachusetts before health care reform, the detection of testicular cancer has more than doubled and the majority of cases are now detected at an early stage. And with wider access to screenings, we’ve seen a 36% decrease in cervical cancer in women.
Those are the stats. But even better are the stories. I remember meeting a young woman named Jaclyn Michalos, a cancer survivor who got the care she needed to save her life through the Commonwealth Connector, our version of the Exchange. She had no affordable way before Massachusetts’s health care reform – it saved her life.
A self-employed man named Ken Brynildsen ignored his gastrointestinal symptoms for 3 years because he could not afford to see a doctor or pay for possible treatments. Once insured, he was seen and treated for Stage III colon cancer and is cancer free today.
By using these new tools and new approaches to how we pay for care, we will avoid nearly a billion dollars in cost increases in this fiscal year.’
Patrick also calculates that current health care cost control efforts are enabling the state to “avoid nearly a billion dollars in cost increases in this fiscal year and another several hundred million more next year.” The wording, as you see, is careful, but the message is clear: Massachusetts is starting to contain health costs.
Readers? Do you agree? Here’s an excerpt: Continue reading
In the Bedford-Stuyvesant neighborhood of Brooklyn where Diane Patrick grew up, in her family of “proud West Indians,” mental illness was “unspeakable” and depression was something “only wealthy people allowed themselves to have.” If you had depression, you were either “truly crazy” or a “self-focused, narcissistic type” who went to “an overpaid, enabling and indulgent therapist.”
Fast forward to 2007. Diane’s husband, Massachusetts governor Deval Patrick, stood before a gaggle of cameras and microphones and told the world that Diane was suffering from depression and would be taking some time out. She was terrified of how people would react, worried that she’d never hold her head high again.
But being open about her condition ended up bringing her an outpouring of compassion — and she spoke about that outpouring, fittingly enough, at a recent dinner held by the Schwartz Center for Compassionate Healthcare. The center has now posted her speech in its entirety in the video above. In case you don’t have the 28 minutes to watch — and that would be too bad, because it’s a rare treat to watch such an obviously intelligent, authentic woman speak from the halls of power about her personal experiences with mental illness — here are five things that struck me:
1. Remember all those gaffes in the beginning of the first Patrick term, the expensive curtains and Cadillac? The stress of those early days in power seemed to help push Diane into depression.
2. A lawyer, Diane had been concerned about how clients and colleagues would react to news of her depression. In fact, she said, some ended up coming into her office on the QT and telling her “they knew exactly what I was going through because they were, too.”
3. William Styron and William James, among others, have tried to capture how terrible depression feels in their writing, Diane noted; “In my words, it’s hell, and it hurts in a way that’s not easy to describe.” You “wake up every day dreading the day ahead.” Continue reading
Rachel Zimmerman reports:
Gov. Deval Patrick, speaking today at the 2011 Massachusetts Health Care Cost Trends Public Hearing, pretty much stuck to his theme that the second phase of health reform is coming, like it or not, and without effective solutions for containing medical costs, no economic recovery will stick.
There were a few new subtleties in Patrick’s testimony, however. First, he didn’t mention the term “global payment” in his remarks. (He told reporters later that accountable care organizations and global payments were basically interchangeable concepts, so his not mentioning global payments was not significant.) Still, his non-mention comes less than a week after Attorney General Martha Coakley issued a report saying that so far, global payment agreements have not brought costs down and are not likely to do so any time soon.
Also, Patrick said that he wants to highlight the fact that the insurance commissioner should have “explicit” authority to deny premium increases if they are based on inequitable reimbursement rates to providers. He also reiterated that he wants a bill passed this fall.
Here, edited and condensed, are seven points the governor made:
1.The cost of health care is going up at an unsustainable rate. Fixing it is “an urgent challenge… failing to do so will threaten our economic recovery.”
2. We’ve already made progress: 99.8 percent of children in Massachusetts are insured and 98 percent of adults now have health insurance following the 2006 reform law. Patrick said that more private companies are offering insurance, and insurance can’t be pulled when a person gets sick. “It’s affordable,” he said. And “it stands as a value statement: health is a public good, everyone deserves access.”
3. There’s an emerging consensus on solutions on how to contain costs. “Whole-person care” works, and moving away from fragmented, fee-for-service care is imminent. Continue reading
By Carey Goldberg and Rachel Zimmerman
“Our examination found that paying providers on a global basis has not resulted in lower total medical expenses.”
It’s just a short, no-frills sentence, but it amounts to a bombshell dropped on a central tenet of the Massachusetts governor’s plan for the next phase of health reform.
That finding anchors a report issued this morning by state Attorney General Martha Coakley. And it appears to contradict Gov. Deval Patrick’s argument that shifting to global payments is a key to “cracking the code” of ever-spiraling medical costs.
The attorney general also found that wide price disparities unrelated to the quality of care still persist from one Massachusetts hospital to another, largely dependent on the providers’ clout in the marketplace. And the report unearthed a counterintuitive trend: residents from the richest zip codes in the state are spending on average far more on health care than people living in poorer neighborhoods. Yet premiums vary little, so in effect, it appears that lower-income people are subsidizing the care of the wealthy.
Global payments are supposed to re-align doctors’ incentives and put a stop to the rise in costs. Under such a global system, instead of being paid for each specific treatment, health care providers are put on an overarching budget for every patient. At the end of a year, if they’re within the budget and meet quality standards, they can win bonuses; if not, they risk penalties. The Patrick administration and private insurers have been pushing doctors toward this model, saying it leads to better, thriftier practices.
But Martha Coakley says: “Our investigation shows that a move to global payments is not the panacea to controlling costs.” The attorney general’s report suggests that in fact, thus far, care has tended to end up costing more under global budgets rather than less. Continue reading
Are Massachusetts mental health cuts implicated in last January’s murder of a group home staffer in Revere? That’s the central question of a New York Times feature online here.
The piece by Deborah Sontag connects the dots from the deinstitutionalization of psychiatric patients, to budget cuts, to inadequate staffing and training in group homes.
It acknowledges that Massachusetts is better on many of these issues than other places, but still…Stephanie Moulton was killed on Jan. 20 when she was alone in the Revere group home with Deshawn James Chappell, described as a schizophrenic patient with a history of violence. Is the system to blame? The piece doesn’t come right out and say so, but here are two key excerpts:
“People are reeling right now,” Dr. Kenneth Duckworth, a former medical director for the State Department of Mental Health, said after the killing. “Will this case be the canary in the coal mine? Will it signal that we’ve gone too far in reducing client-staff ratios, in closing hospitals, in pushing independence for people who may still be too sick?”
“The outpatient treatment system in Massachusetts is dying on the vine,” said Vicker V. DiGravio III, the chief executive of the Association for Behavioral Healthcare, which represents providers in the state….
“The end result,” Mr. DiGravio said, “is a system where the folks with the least professional experience are serving the clients with the most intensive needs — because the Department of Mental Health serves only those people with the most severe mental illness.”
BOSTON – June 1, 2011 – The Patrick-Murray Administration today announced that Dr. Julian Harris has been appointed to serve as Director of the Office of Medicaid, a state program that provides comprehensive health insurance for more than 1 million children, families, seniors and people with disabilities in Massachusetts.
Dr. Harris – who has served in a wide range of organizations – currently practices primary care at the Southern Jamaica Plain Community Health Center and hospitalist medicine at the Cambridge Health Alliance, both of which serve populations with high levels of participation in MassHealth and other state health programs. He is a clinical fellow on the faculty at Harvard Medical School and a senior resident in internal medicine and primary care at the Brigham and Women’s Hospital and its affiliated Southern Jamaica Plain Community Health Center. He formerly served at the World Bank, where he was charged with day-to-day management of the World Bank Institute’s AIDS program. He also worked on national health payment and delivery system reform for an international client at McKinsey & Company.
“Massachusetts is a national leader in expanding access to health care, and we are now at the forefront of cost containment efforts,” said Governor Deval Patrick. “As Medicaid Director, Dr. Harris will play a vital leadership role in our nation-leading efforts provide high-quality, cost-efficient care for our most vulnerable populations.”
The announcement doesn’t specify the fate of the current director, Terry Dougherty. It says only:
“Dr. Harris will assume his new role on July 18. Current Medicaid Director and Assistant Secretary for Administration and Operations Terry Dougherty will remain with the Executive Office of Health and Human Services through August to ensure a smooth leadership transition.”
The Massachusetts Medical Society welcomed the new director: Continue reading