This report presents the results of a study analyzing the impact of the Community Support Program for People Experiencing Chronic Homelessness (CSPECH) on the utilization and cost of health care services. CSPECH is an innovative program through which MassHealth reimburses community-based support services provided to chronically homeless individuals residing in permanent supportive housing. Findings show that coupling supportive services like the type provided by CSPECH with permanent housing can lead to substantial improvements in housing stability and significant reductions in the utilization of acute health care services.

Findings from this report were featured at a Foundation event held on March 8, 2017. Click here to learn more about the event.

Despite the near-universal health insurance coverage that the state has maintained for nearly a decade, pockets of high uninsurance remain for both adults and children in communities across Massachusetts. This brief, prepared by the Urban Institute, explores the relationship between community characteristics and the uninsured rate for people of all ages in Massachusetts and highlights the geographic and community context of the remaining uninsured. It also provides data to better target outreach and enrollment activities.

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.

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.

From 2008 through 2011, the Foundation supported 11 community-based coalitions across Massachusetts through its Closing the Gap on Health Care Disparities Initiative. This report, prepared by Mary Coonan and Terry Saunders Lane of The Center for Social Policy, University of Massachusetts Boston, explores areas of coalition development, system change, and public awareness. It articulates strategies that worked well, challenges that emerged, and factors that explain variation to inform foundations, community organizations, and health care institutions working to address disparities in health care and outcomes. 

In 2005, the Foundation launched the Closing the Gap on Racial and Ethnic Health Care Disparities grantmaking area and secured the Disparities Solution Center at Massachusetts General Hospital as an evaluation partner. This report highlights stories of change from policy, organizational, provider, and client perspectives. Lessons from this report guided the Foundation in revising its funding strategy for the subsequent 2008–2011 grantmaking cycle.

This policy brief based on data from the 2009 Massachusetts Health Reform Survey shows that women have achieved significant gains in insurance coverage and in access and use of health care since health reform was implemented in Massachusetts. The gains were particularly strong for subgroups of women who had lower levels of coverage and poorer access prior to reform, including lower-income women, women of minority race/ethnicity, and women without dependent children.

This policy brief by Sharon Long of The Urban Institute measures geographic and racial disparities in access to health care in Massachusetts. The data in the brief comes from the third annual Massachusetts Health Reform Survey. This revised version of the policy brief, which was originally published 5/28/2009, reflects changes made after an error in constructing survey weights was discovered and corrected. These changes do not impact the basic findings and conclusions in the original policy brief with respect to geographic differences; however, it does lead to more evidence of racial/ethnic differences in the affordability of health care in Massachusetts.

The 2006 Massachusetts health care reform law included a provision to make Medicaid hospital rate increases contingent upon quality measures, including measures of the reduction of racial and ethnic disparities. To date, no other pay-for-performance programs have incorporated measures of the reduction of racial and ethnic disparities into their incentives. MMPI organized the Massachusetts Medicaid Disparities Policy Roundtable to bring together a group of experts to develop and recommend an approach to implementing the program. The Roundtable's recommendations are detailed in this white paper.