UPDATED (June 2016) chart pack produced by the Massachusetts Medicaid Policy Institute (MMPI), a program of the Blue Cross Blue Shield of Massachusetts Foundation, in partnership with the Center for Health Law and Economics at the University of Massachusetts Medical School. This updated edition includes MassHealth enrollment as of January 2016 and spending from state fiscal year 2015 and is made available in PDF and Power Point formats to facilitate its use in presentations.

The Foundation hosted a webinar with authors Bob Seifert and Carol Gyurina from the Center for Health Law and Economics, University of Massachusetts Medical School to review the updated summary data on MassHealth enrollment and spending on Wednesday, June 29, 2016.

Click here to access the webinar slides.

International comparisons of industrialized countries show that those with a higher ratio of social service spending relative to health care spending have better health outcomes. This finding is consistent with decades of research underscoring the importance of social, behavioral, and environmental factors on health outcomes. This report, prepared by a team led by Elizabeth Bradley and Lauren Taylor of the Yale Global Health Leadership Institute, examines the link between state-level spending on health care and social services and health behaviors and outcomes for Massachusetts compared with neighboring states and national averages.

This report, prepared by Manatt Health, lays out a vision for MassHealth long-term services and supports (LTSS) that is person-centered, integrated, sustainable, accountable, and actionable, providing Massachusetts policymakers with a set of options to consider when tackling some of the most intractable challenges facing the Commonwealth’s LTSS system.

The vision and policy areas addressed in the report were identified through the development of a data chart pack and supplemental interviews with consumers, government officials, community and institutional LTSS providers, health plans, and workforce representatives.

Findings from this report were featured at a Foundation event held on May 10, 2016, MassHealth Matters II: Options for Reforming Long-Term Services and Supports. Click here to learn more about the event.

Chapter 58 of the Acts of 2006—“An Act Providing Access To Affordable, Quality, Accountable Health Care”—was signed into law by Governor Mitt Romney on April 12, 2006. The groundbreaking law sought near-universal health care coverage for the residents of Massachusetts by expanding Medicaid, creating a new program of subsidized insurance, enacting changes to the health insurance market, and requiring adults to have health insurance unless an affordable option was not available.

As we mark the occasion of the 10th anniversary of Chapter 58’s enactment, this fact sheet, prepared by Kelly Love and Robert Seifert of the Center for Health Law and Economics at the University of Massachusetts Medical School, presents a summary of the law’s effects, as reported in the many studies that have focused on Massachusetts’ reform. This high-level review summarizes the findings in various categories, including insurance coverage, access to care, health care utilization, and affordability for consumers. The authors also developed a full bibliography as a companion to the fact sheet.

This collection of reports and chart packs is the latest in a series by the Urban Institute analyzing the results of the Massachusetts Health Reform Survey (MHRS) which has been conducted most years since 2006, the year that Commonwealth enacted comprehensive health care reform. The 2015 MHRS, conducted  in the fall of 2015, provides an assessment of the state's efforts to improve the affordability of care and reduce health care spending through the cost containment legislation titled “An Act Improving the Quality of Health Care and Reducing Costs Through Increased Transparency, Efficiency and Innovation” (Chapter 224 of the Acts of 2012). It also assesses the impact of the federal Affordable Care Act (ACA) that began in January 2014.

The 2015 MHRS highlights sustained gains in health insurance coverage since the passage of Massachusetts’ 2006 health care reform law, as well as persistent gaps in health care access and affordability for many of those with insurance coverage. Low-income adults and those with health problems tend to be disproportionately impacted by these gaps. The survey findings are a reminder that the goals of health care reform are not fully achieved by simply reducing the number of people who are uninsured. New strategies are needed to improve access to care and reduce the burden of health care costs for Massachusetts families with insurance coverage, particularly for those made more vulnerable by limited resources and high health care needs.

This year’s results are presented in a variety of publications including:

• Summary
• Full narrative report
• Chart pack
• Infographic

In an effort to expand opportunities for researchers to understand the experience of Massachusetts consumers with accessing and affording health care, the Blue Cross Blue Shield of Massachusetts Foundation will be making available a public use file of the 2015 survey as they did with the previous years’ surveys (i.e., 2006 – 2010, 2012-2013). The 2015 public use files will be available through the Inter-University Consortium for Political and Social Research.

On Tuesday, April 19th, the Foundation hosted a webinar to review key findings from the 2015 Massachusetts Health Reform Survey with author Sharon Long of the Urban Institute. Click here to access the webinar slides.

This report, prepared by Robert Belfort and Alex Dworkowitz of Manatt, Phelps & Phillips, LLP, provides a review of the primary Massachusetts and federal privacy laws relevant to the exchange of information among physical and behavioral health providers and an assessment of technological and operational challenges faced by providers seeking to integrate care through enhanced data exchange. The report proposes ways in which existing laws could be clarified or amended to better facilitate information exchange and identifies potential operational strategies for minimizing the restrictive impact of existing privacy laws without compromising patient privacy.

The Foundation hosted a webinar with authors Robert Belfort and Alex Dworkowitz of Manatt, Phelps & Phillips, LLP to review key findings from this report on Wednesday, March 30th. Click here to access the webinar slides.

This chart pack provides updated MassHealth enrollment data as of November 2015.

Although Massachusetts has successfully achieved the lowest rate of uninsurance in the nation, thousands of individuals and families still live with the potential adverse health effects and financial impacts of not having health insurance. In 2015, an estimated 200,000 individuals in Massachusetts did not have health insurance coverage. This report, prepared by a team led by Michael Chin and Deborah Gurewich of the University of Massachusetts Medical School, and Audrey Gasteier of the Commonwealth Health Insurance Connector Authority, summarizes the findings of a qualitative study in which 33 uninsured individuals were interviewed about their experience living without health insurance. Findings from this study can help to better understand the remaining barriers to coverage and inform future strategies aimed at reducing the number of uninsured in the state. The report concludes with the personal stories of five individuals who have experienced first-hand the challenges and consequences of being uninsured.

This chart pack, prepared by Manatt Health Solutions, provides an examination of the current state of long-term services and supports (LTSS), an area identified as a priority for reform by MassHealth (Massachusetts Medicaid). MassHealth accounts for nearly half of all spending on LTSS, amounting to $4.5 billion annually, and equal to 12 percent of the state budget. Using previously unpublished LTSS data, the chart pack examines MassHealth LTSS spending and utilization, access and affordability, workforce capacity and quality. It also includes a summary of opportunities to improve delivery and coordination of LTSS.

Findings from this chart pack were featured at a Foundation event held on December 2, 2015, MassHealth Matters II: Long-Term Services & Supports (LTSS): Opportunities for MassHealth.

This primer, prepared by Ellen Breslin of Health Management Associates, includes an explanation of how state Medicaid programs generally pay their MCOs, the overall process for setting Medicaid managed care capitation rates and the various tools that states use to mitigate the risks that MCOs face when they assume financial responsibility for Medicaid members.

In March 2010, President Obama signed The Patient Protection and Affordable Care Act (ACA), which included significant changes impacting health insurance coverage across the United States. Although many elements of the ACA were based on Massachusetts’ health insurance reform, there were still many decisions and activities that Massachusetts needed to address in order to comply with the new federal Medicaid and health insurance marketplace requirements, most of which were required to be effective as of January 2014. This issue brief, prepared by Health Management Associates, focuses on the changes in eligibility, benefits, cost sharing (including premiums), and health plan options available to individuals receiving subsidized insurance in the Commonwealth before and after implementation of the ACA.

The “ Making Health Care Affordable” (MHCA) three-year grant program concluded in 2014. Margaret Houy and Kate Bazinsky of Bailit Health Purchasing, LLC report on the impact of the BCBSMA Foundation’s funding initiative. The goal of MHCA was to fund interventions aimed at containing costs while increasing access and quality of care. Bailit examines how the Foundation’s objectives were met, what factors led to successful program implementation, common barriers faced by grantees, and which programs may have generalizability.

UPDATED (July 2015) chart pack, prepared by the Center for Health Law and Economics at the UMass Medical School, includes summary data on MassHealth enrollment and spending and is designed to support use of the charts in presentations. Updated edition includes MassHealth enrollment as of March 2015 and spending from state fiscal year 2014.

Social determinants of health, which encompass social, behavioral and environmental influences on one’s health, have taken center stage in recent health policy discussions. While research indicates that greater attention to these non-medical factors may improve health outcomes and reduce health care costs, translating this evidence into actionable recommendations for policy makers and others has been challenging. This report, prepared by a team led by Elizabeth Bradley of the Yale Global Health Leadership Institute and Lauren Taylor of the Harvard Divinity School, evaluates and synthesizes the evidence base for interventions that address social determinants of health, with special attention to innovative models that may improve health outcomes and reduce health care costs and that may be applicable in the Massachusetts policy context. Based on this review, there is strong evidence that increased investment in select social services (e.g., housing support and nutritional assistance), as well as various models of partnership between health care and social services (e.g., integrated health care and housing services), can result in substantial health improvements and reduced health care costs for targeted populations.

This report, prepared by Sharon Long and Thomas Dimmock of the Urban Institute, further analyzes the 2013 Massachusetts Health Reform Survey (MHRS) by comparing the experience of adults with public coverage to adults with employer-sponsored insurance (ESI) coverage across a number of access and affordability measures. Findings from the analysis show problems with access to care were more prevalent for adults with public coverage than for those with ESI. These disparities persist even after controlling for variations in health care needs and socioeconomic status between the two groups. The persistence of gaps in access to care for adults with public coverage raises concerns about systemic barriers to care within the Massachusetts health care system.

In conjunction with the full report, the authors developed a one-page summary highlighting key findings from the analysis.