The goal of this study was to better understand whether Primary Care Providers (PCPs) identify a need for a PCP-to-behavioral health (BH) provider consultation program for adult patients with mental health conditions and substance use disorders (SUDs), and whether they would utilize such a program. Additionally, the study sought to understand the type of BH conditions providers encounter, the proportion of adult primary care patients with BH needs, and the challenges PCPs face in supporting adult patients with BH conditions. These findings are intended to help stakeholders understand how a consultation program might be best structured to provide evidence-based support to PCPs and, in turn, their patients with BH needs.

The Blue Cross Blue Shield of Massachusetts Foundation today announced that thirteen medical journalists from across the nation have been selected for the 2022 class of the Health Coverage Fellowship.

The 2022 fellows are Anjuman Ali of the Washington Post, Caitlin Andrews of the Bangor Daily News, Hadley Barndollar of the USA Today Network, Isabella Cueto of STAT News, Erika Edwards of NBC News, Gabrielle Emanuel of WBUR Radio in Boston, Karen Brooks Harper of the Texas Tribune, Pien Huang of NPR, Lesley McClurg of KQED Radio in San Francisco, Andrea Petersen of the Wall Street Journal, Emily Alpert Reyes of the Los Angeles Times, Amanda Sealy of CNN, and Isabelle Taft of Mississippi Today.

The fellowship is designed to help the media improve its coverage of critical health care issues. It does that by bringing in as speakers more than 75 health officials, practitioners, researchers, and patients. It also brings the journalists out to watch first-hand how the system works, from walking the streets at night with mental health case workers to visiting the world’s biggest brain bank.

The program, which is entering its twenty-first year, is sponsored by the Blue Cross Blue Shield of Massachusetts Foundation, with support from the Blue Shield of California Foundation, Bower Foundation in Mississippi, Endowment for Health in New Hampshire, Fledgling Fund, Maine Health Access Foundation, National Institute for Health Care Management Foundation, Rita Allen Foundation, Robert Wood Johnson Foundation, and, in Texas, the Episcopal Health Foundation, Meadows Mental Health Policy Institute, Methodist Healthcare Ministries, and St. David’s Foundation.

The fellowship will run for nine days, beginning September 16, 2022. It is housed at Babson College’s Center for Executive Education in Wellesley, MA. Larry Tye, who covered health and environmental issues at the Boston Globe for 15 years, directs the program. A former Nieman Fellow and author of eight books, Tye has taught journalism at Boston University, Northeastern, Tufts, and Harvard.

Next fall’s fellowship will focus on a series of pressing issues – from preventing future pandemics to treating mental illness, rooting out racial and ethnic inequalities, redressing homelessness, and rethinking later-life care. Attention also will be given to breakthroughs in medical treatments and curbing health-care costs.

The teaching will not end when fellows head back to their stations or papers. Tye, the program director, will be on call for the journalists for the full year following their nine days in Wellesley. He will help when they are stuck for ideas or whom to call on a story. He also will assist in thinking out projects and carving out clearer definitions of beats.

About the Blue Cross Blue Shield of Massachusetts Foundation

The mission of the Blue Cross Blue Shield of Massachusetts Foundation is to ensure equitable access to health care for all those in the Commonwealth who are economically, racially, culturally or socially marginalized.  The Foundation was established in 2001 with an initial endowment from Blue Cross Blue Shield of Massachusetts.  It operates separately from the company and is governed by its own Board of Directors.  More information on the foundation is available at www.bluecrossmafoundation.org, and on the Health Coverage Fellowship at www.bluecrossmafoundation.org/programs/health-coverage-fellowship.

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The Blue Cross Blue Shield of Massachusetts Foundation released survey findings today that provide the first comprehensive picture of behavioral health needs among Massachusetts adults and their persistent challenges in accessing mental health care and substance use disorder treatment during the first year of the COVID-19 pandemic.

According to the Massachusetts Health Survey – commissioned by the Foundation to better understand behavioral health needs and the gaps in the health delivery system amid the pandemic – more than 1 in 3 adults reported needing behavioral health care for themselves or a family member over the prior 12 months.

Among those who reported needing behavioral health care, 26% did not receive any behavioral health care.  The level of need was disproportionately higher among younger adults (age 19-39), among people of color, and among populations with lower-income.  Those surveyed cited affordability, accessibility and stigma as barriers to getting behavioral health care.

Echoing earlier research, nearly half (49%) of respondents reported job losses or disruptions, and 28% said they consumed alcohol or cannabis more frequently after the pandemic began.  Of concern, almost one in five adults (17%) reported their consumption of alcohol or cannabis had caused serious problems with their personal responsibilities at home, work or school over the previous 12 months.

“The survey clearly shows that what was an urgent need already before the pandemic has reached a level of crisis across our state, particularly in communities of color,” said Audrey Shelto, President and CEO of the Blue Cross Blue Shield of Massachusetts Foundation.  “In my decades of working on behavioral health issues in the Commonwealth, I have never seen such consensus on the degree of the problem and how to address it.  The Baker administration, state Legislature and federal government have all proposed solutions and funding.  Now is the time to act.”

The survey is the first to provide a clear snapshot of behavioral health care needs among a broad group of Massachusetts adults during the first year of the COVID-19 pandemic.  The Foundation’s consultant, NORC at the University of Chicago, an independent, non-partisan research institution, fielded the survey between December 2020 and March 2021, and responses have a 12-month look-back period.

“This quantitative data supports the challenges our health center staff has witnessed on a daily basis,” said Dr. Carlos F. Cappas, Chief Behavioral Health Officer at Lynn Community Health Center.  “The demands on our services are outpacing the supply and we need additional sources of care to address the wide range of behavioral health concerns in the communities we serve.”

Other key findings from the Massachusetts Health Survey include:

• Fewer than half (43%) of the Massachusetts adults who needed behavioral health services reported receiving behavioral health care and always being able to obtain an appointment when they needed care.
• 64% who reported a need for behavioral health care indicated their need was due to, or exacerbated by, the pandemic.
• More than 1 in 4 (27%) Massachusetts adults expected to need behavioral health care over the subsequent six months.  However, nearly one-fifth of those adults did not report needing care over the previous 12 months – representing many new people looking for services.

The full report can be found online at the following link:

https://www.bluecrossmafoundation.org/publication/behavioral-health-during-first-year-covid-19-pandemic-update-need-and-access-0

About the Blue Cross Blue Shield of Massachusetts Foundation

The mission of the Blue Cross Blue Shield of Massachusetts Foundation is to expand access to health care for low-income and vulnerable individuals and families in the Commonwealth.  The Foundation was founded in 2001 with an initial endowment from Blue Cross Blue Shield of Massachusetts.  It operates separately from the company and is governed by its own Board of Directors.

This brief provides an updated snapshot of the need for behavioral health care and experiences accessing it in the Commonwealth as of 2020/2021, based on a new survey commissioned by the Foundation.  This survey was fielded by NORC at the University of Chicago between December 2020 and March 2021 and gathered information on the need for and access to behavioral health care among Massachusetts adults ages 19 and older and their close relatives. The survey gathered information on the experiences of Massachusetts adults during the 12 months prior to the survey, which covered the period January 2020 through March 2021. Given the timing of the survey and its 12-month look-back period, the survey collected information over roughly the first year of the COVID-19 pandemic. The survey also included a series of questions focused explicitly on the link between the COVID-19 pandemic and the need for behavioral health care.

The Blue Cross Blue Shield of Massachusetts Foundation today announced it has awarded the first grants through its new Racial Justice in Health program that will support grassroots nonprofit community organizations led by people of color.  These grants were part of the Foundation’s overall grantmaking activity in 2021 that totaled nearly $4 million and continued philanthropic support for dozens of statewide initiatives involving behavioral health and health care access.

The Racial Justice in Health program aims to strengthen the grant partners’ capacity and expertise in health care advocacy, through peer learning and technical assistance.  The selected organizations are committed to dismantling institutional and structural racism in health care.  The two-year program is supported by two funding partners, Rx Foundation and CareQuest Institute for Oral Health.

“These initial grants will enhance the capacity of grassroots organizations led by people of color to influence positive change in the health-related challenges that most concern their communities,” said Audrey Shelto, President and CEO of the Blue Cross Blue Shield of Massachusetts Foundation.  “Our goal is to advance policies and practices that promote racial justice and health equity, and for those policies to be shaped and led by those who are most impacted.”

The following organizations received $50,000 each in an initial year of funding for their initiatives involving community engagement, building grassroots power and developing campaigns:

• Asian Women for Health, a peer-led, statewide network based in Somerville dedicated to advancing the health and well-being of Asian women, including cancer survivors and immigrants, through education, advocacy and support.
• Brookview House, a Black and Latinx women-led nonprofit organization in Dorchester that provides support services and programs that confront the root causes of homelessness and poverty for low-income mothers and works for justice, equity and systemic change for low-income families.
• GreenRoots, an organization that bridges environmental justice and public health by engaging the most impacted residents in the highly industrial neighborhoods of Chelsea and East Boston.
• La Colaborativa, which empowers Latinx immigrants in the Chelsea area to enhance the social and economic health of the community and to hold institutional decision-makers accountable to the community.
• Legendary Legacies, a Worcester organization that provides case management, mentoring, skills development, and re-entry services for young men of color, including fathers and previously incarcerated or gang-affiliated individuals.
• Pioneer Valley Workers Center, a Northampton nonprofit that builds the collective power of low-wage and immigrant workers in Western Massachusetts’ agricultural and restaurant industries.
• Somali Development Center, a Roxbury-based nonprofit providing educational and social services to refugees and immigrants in Greater Boston who are primarily from Somalia, Ethiopia, Eritrea, Sudan and Djibouti.
• The Welcome Project, a Somerville-based nonprofit organization that builds the collective power of immigrants to participate in and shape community decisions through programming for youth and adults and families.

The Foundation’s grantmaking activity in 2021 included a third and final year of funding through the Expanding Access to Behavioral Health Urgent Care program for six community-based organizations; one year of funding to support 14 community health centers and community-based organizations deliver health insurance navigation and enrollment services through the Connecting Consumers with Care program; and two years of operational support to 11 health advocacy organizations through the Strengthening the Voice for Access grant program.

The Foundation also continued to provide one-time grants through its Special Initiatives program, supporting 12 nonprofit organizations that are working to improve health care access for Massachusetts residents who have been economically, socially, ethnically or racially marginalized.

About the Blue Cross Blue Shield of Massachusetts Foundation

The mission of the Blue Cross Blue Shield of Massachusetts Foundation is to expand access to health care for low-income and vulnerable individuals and families in the Commonwealth.  The Foundation was established in 2001 with an initial endowment from Blue Cross Blue Shield of Massachusetts.  It operates separately from the company and is governed by its own Board of Directors.  For more information, visit www.bluecrossmafoundation.org.

The Blue Cross Blue Shield of Massachusetts Foundation today released a new study confirming that people of color in Massachusetts face persistent and pervasive health inequities, and called on policymakers and stakeholders to act collectively to implement solutions in partnership with those affected by structural racism.

Developed in collaboration with Manatt Health and guided by an advisory group of health equity experts from across the state, the research report provides a comprehensive resource to broaden understanding of racial and ethnic health disparities in Massachusetts and identifies distinct data gaps that, if addressed, can support collective action and accountability.

The study paints a clear picture that Black and Hispanic people are much more likely to lack health insurance and face cost-related barriers to care, limiting their access to routine medical care and adversely affecting their health outcomes.  These disparities are longstanding but were further exposed during the COVID-19 pandemic, which disproportionately affected people of color.

“The data show widespread health disparities experienced by racial and ethnic groups in Massachusetts, enough information to take action.  In addition, our research team identified limitations in state data that could hamper our efforts to collectively monitor the impact of efforts to address them,” said Audrey Shelto, President and CEO of the Blue Cross Blue Shield of Massachusetts Foundation.  “We stand ready and eager to participate in any coordinated approaches to improve race and ethnicity data and in collaborative efforts to fulfill our moral imperative to address the disparities and achieve health equity.”

The advisory group of health equity experts helped identify the need for a common set of data that would allow for better coordination and collective accountability.  The research team found that a lack of standard categories, and the aggregation of too many populations into the categories that do exist, mask significant variation with the population categories.

The data show that Black and Hispanic people receive worse care across a broad range of quality measures and experience higher rates of many adverse health outcomes, including infant or neonatal mortality, diabetes, asthma, and HIV mortality.  People of color are also significantly more likely to be hospitalized or die as a result of COVID-19.

The Foundation believes that organizations including the Massachusetts Department of Public Health, the Health Policy Commission and the Center for Health Information and Analysis are well-positioned to advance efforts to strengthen data availability for public analysis.  The Commonwealth could consider facilitating public-private partnerships with providers, payers, community-based organizations and other stakeholders.

According to the report, the root causes of health disparities in Massachusetts are complex and due to many factors, driven by historical and pervasive structural racism.  There are many financial factors that create barriers to gaining access to health care, as well as social conditions that affect health and well-being, among people of color.

“There are numerous organizations across the state doing work in our own communities to address these known health inequities and that work clearly needs to continue in light of these findings,” said Frank Robinson, Vice President of Baystate Health and a member of the advisory group.  “But the report also underscores the need to collaborate to define our goals as a state so that we can mark our progress.”

The full report, titled “Racism and Racial Inequities in Health in Massachusetts: A Data-Informed Primer on Health Disparities in Massachusetts,” is available online at: https://www.bluecrossmafoundation.org/publication/racism-and-racial-inequities-health-data-informed-primer-health-disparities

About the Blue Cross Blue Shield of Massachusetts Foundation

The mission of the Blue Cross Blue Shield of Massachusetts Foundation is to expand access to health care for low-income and vulnerable individuals and families in the Commonwealth.  The Foundation was established in 2001 with an initial endowment from Blue Cross Blue Shield of Massachusetts.  It operates separately from the company and is governed by its own Board of Directors.  For more information, visit www.bluecrossmafoundation.org.

This primer serves as a foundational resource to broaden the collective understanding of racial and ethnic health inequities and disparities in the Commonwealth as part of our new focus area of Structural Racism and Racial Inequities in Health. The primer is intended to support discussion about how our health care system and other systems that impact health enhance or undermine health, and to facilitate the development of solutions to strengthen those systems to serve all Massachusetts residents.

The primer presents a data-informed reflection of the racial and ethnic health inequities and disparities Massachusetts residents confront today. It offers a basis for further discussion and action, including to evolve and improve the data resources that shed light on racism and racial inequities in Massachusetts’ social and health care systems. The Foundation’s work in this focus area will aim to identify and elevate health care policies and practices that will advance health equity and reduce health disparities in the Commonwealth.

To the extent possible in the confines of a data-focused report, the primer acknowledges critical context about the historical and structural contributors to the racial and ethnic health inequities and disparities that exist today. Data limitations and gaps are noted throughout, identifying where new or improved data is needed to provide a comprehensive, cohesive, and actionable set of data to support the Commonwealth’s health equity goals.

As a program that provides publicly-funded health benefits to more than 2 million low-income children and families, seniors and people living with disabilities in Massachusetts, it is not surprising that MassHealth accounts for a large share of the state’s budget.  However, a cursory review of the MassHealth budget can be misleading because it can obscure the billions of dollars in federal revenue that the program generates for the state. This brief looks beyond the budget totals to help stakeholders better understand the actual state cost of MassHealth by accounting for the state and federal partnership that finances this program.

In state fiscal year (SFY) 2022, the state projects it will spend approximately $19.2 billion on MassHealth. This total (or “gross” amount) is approximately 36 percent of total estimated state spending for SFY 2022. However, because the federal government reimburses Massachusetts for more than half of its MassHealth spending, the state’s actual cost for MassHealth (“net of”—or minus—federal revenue) is $8.5 billion or 22 percent of the total state spending in SFY 2022. Fully understanding the actual state cost of MassHealth requires appreciating the details of the federal and other revenue sources that support this essential and comprehensive program.

The Blue Cross Blue Shield of Massachusetts Foundation today announced the Massachusetts Institute for Community Health Leadership (MICHL) 2021-2022 class, a group of 16 diverse professionals who will advance their leadership capabilities and learn new practices and strategies designed to increase their personal impact and strengthen their organizations’ role in building a more equitable health care system.

“MICHL is a vital tool for preparing our next generation of health care leaders,” said Audrey Shelto, president of the Blue Cross Blue Shield of Massachusetts Foundation.  “The program is designed to equip participants with the skills and knowledge that enable them to lead in key areas including addressing the inequities in our existing health care system.  We have seen many graduates go on to become leaders of their organizations and in their communities.”

The experiential program brings together emerging leaders who currently direct or manage programs at a variety of health care organizations across Massachusetts for a series of classroom, peer-to-peer and professional learning opportunities.  Since 2014, the program has had a particular focus on structural racism and racial inequities in health care.

“Our emphasis on structural racism will continue with the current cohort as we explore how the racial justice movement of 2020 and the ongoing COVID-19 pandemic have affected the lives of people of color who depend on the health care system, and made more visible the advantage of white people in accessing that system,” said Michael McCormack, director of the MICHL program.

The MICHL participants, selected through an application process, include developing leaders from public health departments, community health centers, behavioral health providers, advocacy groups, hospitals, and academia.  The program began in 2005, features expert faculty with varied backgrounds, and counts more than 180 graduates who have advanced their careers and enhanced their effectiveness as leaders in community health.

“I was part of the first cohort and MICHL came at just the right time in my career,” said Dr. Monica Bharel, who was medical director of the Barbara McInnis House at the time and later became commissioner of the Massachusetts Department of Public Health.  “The program allowed me the space to think about my goals and strengths.  It taught me concrete skills in many areas, such as communication and facilitative leadership, that I still use today.”

MICHL is an 18-day educational program presented over the course of nine months, with some sessions presented virtually due to COVID-19 guidelines.  The Foundation underwrites the majority of costs associated with the program.

The 2021-22 MICHL participants are:

• Theresa Alphonse, Program Manager, Community Partners & Health Equity, Steward Health Care Network
• Jasmine Bland, Manager, Massachusetts Health Policy Commission
• Manuel Gonzalez, Director Payor Programs, Beth Israel Lahey Performance Network
• Daniela Johnson, Director of Clinical Practice, Vinfen
• Claudine Joseph, Program Coordinator, Center for Primary Care/Harvard Medical School
• John Kane, Coordinator of Grants & Strategic Partnerships, Boston Housing Authority
• Anna Kaplan, Director of Epidemiology & Data Services, Cambridge Health Alliance
• Erica Marshall, Deputy Director, Division of Health Protection & Promotions, Massachusetts Department of Public Health
• Daphne Mazuz, Lead Technical Assistance Manager, Centering Healthcare Institute
• Gina Patterson, Director of Boston Opportunity Systems, Boston Medical Center
• Angelina Ramirez, Chief Executive Officer, Stavros Center for Independent Living
• Sarimer Sanchez, Infectious Diseases Bureau Director, Boston Public Health Commission
• Karen Schoenherr, Associate Director of Training & Organizational Development, Planned Parenthood
• Gary Sing, Director of Delivery System Investment & Social Services Integration, Office of Payment and Care Delivery Innovation, MassHealth
• Jaime Tirrell Hassey, Speech Language Pathologist, MGH Chelsea HealthCare Center
• Ayn Yeagle, Executive Director, Growing Places

For more information about MICHL, please visit:

https://www.bluecrossmafoundation.org/programs/massachusetts-institute-community-health-leadership

About the Blue Cross Blue Shield of Massachusetts Foundation

The mission of the Blue Cross Blue Shield of Massachusetts Foundation is to expand access to health care for low-income and vulnerable people in the Commonwealth.  The Foundation was founded in 2001 with an initial endowment from Blue Cross Blue Shield of Massachusetts.  It operates separately from the company and is governed by its own Board of Directors.

In response to the health and economic damage caused by the COVID-19 pandemic, Congress passed the American Rescue Plan Act (ARPA) in March 2021, which makes $1.9 trillion available to individuals, states and territories, counties, cities, community organizations, educational institutions, and other entities. Some funds are intended to shore up or even expand programs and agencies that have been depleted during the pandemic, while other funds are designated or available to create new programs. ARPA contains many health-related provisions, with particular focus on behavioral health services (inclusive of mental health and substance use care), the health care workforce, and programs that make health insurance coverage and health care available to more people. This summary focuses on the key components of ARPA that will affect health care in Massachusetts.