Alternative Payment Models and the Case of Safety-Net Providers in Massachusetts

Megan Burns and Michael Bailit of Bailit Health Purchasing, LLC, provide a comprehensive review of payment reform in Massachusetts and, in particular, how the changing landscape is affecting safety-net providers. For this report, safety-net providers—those providers characterized by serving a high percentage of Medicaid beneficiaries and uninsured individuals—includes both community health centers and hospitals. Building off state-collected data that details the adoption of alternative payment models (APMs) by payers over the course of 2012 and 2013, the report adds qualitative findings gathered from a sample of payers and providers in mid-2014. The qualitative findings focus on the variation in characteristics of Massachusetts global payment arrangements and the impact the contracts are having on safety-net providers. The report concludes with several recommendations that payers, the state, or foundations could provide to aid safety-net providers in their preparation for payment reform.

Chapter 224 Tracking Tool

This tracking tool provides a detailed description of key components of Chapter 224, highlighting the progress the state has made in its implementation of the law. This tool is designed for policymakers, advocates, and other stakeholders who wish to track when and how state leaders may address policy issues that pertain to Chapter 224. This tracking tool is a living document and will be updated regularly. If you have any suggested additions or corrections, please email [email protected].

Investing in Consumer Health Advocacy through Operating Support, Strengthening the Voice for Access: 2011-2013

This report demonstrates how a general-operating-funds approach to grantmaking can forge stronger and more effective partnerships between the philanthropy and consumer health advocacy communities. It includes examples of the positive impact this approach has had on access to health care in Massachusetts and highlights some of the activities and achievements of 2011-2013 Strengthening the Voice for Access grantee organizations.

UPDATED: Health Care Costs and Spending in Massachusetts: A Review of the Evidence

This comprehensive chartpack features, in one easy-to-use resource, data and complete references on topics including Massachusetts health care spending trends, cost drivers, and variations in pricing, as well as key differences in health care cost trends between Massachusetts and the U.S. This chartpack pulls together many of the major findings and analyses from recent state and national research efforts including reports by the Massachusetts Center for Health Information and Analysis and the Massachusetts Attorney General’s Office, as well as analyses by the Centers for Medicare and Medicaid Services and the Dartmouth Atlas of Health Care.

This chartpack was originally assembled by the Foundation in collaboration with Amitabh Chandra at the Harvard Kennedy School of Government and Josephine Fisher at Amherst College, and updates have been made by Foundation staff. This document has been designed to support the use of the charts in slide presentations, and we encourage readers to use them. We plan to update this chart pack regularly.

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Sick in Massachusetts: Views on Health Care Costs and Quality

This poll – conducted in April and May 2012 by researchers at the Harvard School of Public Health – asked “sick” Massachusetts residents a series of questions related their perception of health care costs and quality in Massachusetts, the reasons for cost and quality problems, and their personal experience with cost and quality issues. The results showed that sick residents are very concerned about health care costs in Massachusetts, and some struggle with their own costs of care. Though respondents were less troubled by the quality of care in the state, there were indications of problems, especially around care coordination and communication. The poll was conducted in partnership with 90.9 WBUR and the Robert Wood Johnson Foundation.

Benefits of Slower Health Care Cost Growth for Massachusetts Employees and Employers

This report by Jonathan Gruber of the Massachusetts Institute of Technology models the potential benefits to the economy if health care costs were to grow more slowly than projected. In the face of rising health insurance costs, studies find, employers tend to reduce or blunt the rise of employee wages as well as offer less generous insurance coverage. But employers cannot pass along all the increased costs of health insurance as decreased wages and benefits. Any additional costs must be offset either by cutting jobs or by accepting lower business profits. This report presents three potential scenarios of slower health care cost growth between 2011 and 2019 and models the subsequent impacts on employee wages, employer spending on health insurance as well as employer profits and workforce investments. The report finds that slower growth in premiums would result in billions of dollars in savings for both employees and employers. 

The Interactive Guide to Chapter 288

An online, interactive guide to Chapter 288 of the Acts of 2010, Massachusetts' most recent health care cost containment law. This online tool includes full, up-to-date text, section-by-section summaries and links to relevant reports, commissions, state agencies and final regulations.

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Public Perceptions of Health Care Costs in Massachusetts

This poll, fielded in late September 2011 and led by Robert Blendon at the Harvard Opinion Research Program, probed 1002 Massachusetts adults on various questions surrounding health care costs, including their perceptions of major cost drivers, who they believe should take the lead on addressing costs and how important is it for the state to take major action. The results reveal that the public is greatly concerned over rising costs and ready for the state to take major actions to tackle them.