The fourth edition of the 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 as of November 2017. This tool is designed for policymakers, advocates, and other stakeholders who wish to track when and how state leaders have addressed policy issues pertaining to Chapter 224.

This year’s release includes two distinct versions of the tracking tool: 1) An abbreviated version that focuses on progress the state has made since September 2016; and 2) A more comprehensive version which documents progress the state has made in implementing the law since its passage in 2012.

If you have any suggested additions or corrections, please email [email protected].

The third edition provides a detailed description of key components of Chapter 224, highlighting the progress the state has made in its implementation of the law as of September 2016. This tool is designed for policymakers, advocates, and other stakeholders who wish to track when and how state leaders have addressed policy issues pertaining to Chapter 224.

This year’s release includes two distinct versions of the tracking tool: 1) An abbreviated version that focuses on progress the state has made since August 2015; and 2) A more comprehensive version which documents progress the state has made in implementing the law since its passage in 2012.

This tracking tool is a living document and will be updated annually. If you have any suggested additions or corrections, please email [email protected].

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.

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 report summarizes the results of a July 2015 poll conducted by a team led by Robert J. Blendon, Sc.D. of Harvard T.H. Chan School of Public Health. The poll was conducted to assess the perspectives of Massachusetts adults age 65 and over on the issues of affordability, access, and satisfaction with their health care coverage. The results show that while a large majority of seniors are satisfied with the health care they receive as patients, over one-quarter of older adults are dissatisfied with health care costs, and more than one in five report that it has gotten harder to pay for health care services or prescriptions drugs over the past five years. Both concerns are higher among seniors who report poor health or a disability.

There are almost one million seniors in Massachusetts and while most enjoy broad coverage and protection against the cost of many health care services through Medicare, they may also face significant gaps, finding themselves responsible for substantial deductibles, coinsurance and copayments. This report, prepared by Nancy Turnbull and Katherine Heflin of Harvard T.H. Chan School of Public Health, reviews the many private and public coverage options available to seniors to supplement Medicare coverage. Using publicly available data from state and federal sources, this report examines recent trends and issues in private health insurance coverage and public programs to support payment of out-of-pocket costs for Medicare beneficiaries in Massachusetts.

This updated edition of the 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 as of August 2015. This tool is designed for policymakers, advocates, and other stakeholders who wish to track when and how state leaders have addressed policy issues pertaining to Chapter 224.

This tracking tool is a living document and will be updated annually. If you have any suggested additions or corrections, please email [email protected].

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.

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 Margaret Houy and Michael Bailit of Bailit Health Purchasing, LLC, provides a comprehensive review of the policy and regulatory barriers that impede behavioral health integration in Massachusetts and identifies potential options for addressing these barriers. This report is divided into three sections – licensing, privacy, and, reimbursement barriers – and was developed through a review of reports and other secondary sources, agency regulations and checklists, and interviews and a focus group with key stakeholders. Incorporating the input from the focus group, it concludes with a discussion of the top three priorities that, if addressed, would have the most significant impact on removing barriers to integration. This report is intended to serve as a resource summarizing key issues and potential opportunities for policymakers to improve the integration of physical and behavioral health care services.

In this issue brief, Patricia Boozang, Deborah Bachrach and Hailey Davis of Manatt Health Solutions, review the coverage and delivery system challenges that Massachusetts could address through sections 1331 (the Basic Health Program) and 1332 (Waivers for State Innovation) of the Affordable Care Act (ACA). This brief describes the federal requirements related to these sections of the law and identifies the options the Commonwealth could pursue to advance its coverage, fiscal, and policy priorities, including: improving affordability and ease of access to coverage for low-income residents, continuing the expansion of insurance coverage to hard-to-reach populations, and evaluating and revisiting policy decisions like the individual mandate to determine the best fit for Massachusetts.

Peter Hussey, Courtney Armstrong, and Eric Schneider of the RAND Corporation conducted interviews with seven health plans and five Accountable Care Organizations (ACOs) to determine their support for innovative delivery system models including payment arrangements, program development strategies, and the criteria decide whether or not to support these programs. All interviewees are currently engaged in innovative care delivery efforts aimed at improving quality and reducing the cost of healthcare and believe that the current payment system has not moved far enough away from fee-for-service to support meaningful delivery system changes. The report suggests that a shift towards alternative payment methodologies, an alignment of incentives across payers, and a better understanding of the impact of care delivery transformation are all necessary to achieve sustainability. The authors find that the main challenge in innovation will building capacity and managing financial risk, particularly for smaller and less-experienced provider organizations.

Click here to read the report.

In this report, Carol Gyurina, Jennifer Rosinkski and Robert Seifert of the University of Massachusetts Medical School, analyze several factors that help explain why health care affordability continues to be a challenge in Massachusetts, even after achieving near universal health insurance coverage. Beginning with an analysis of data largely collected through the Massachusetts Health Reform Survey (MHRS), the report provides an overview of the factors influencing health care affordability and summarizes the financial and access to care consequences for consumers struggling with health care costs. The remainder of the report is devoted to sharing the personal stories of four individuals in Massachusetts who have experienced first-hand the challenges and consequences of unmanageable health care costs.

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.

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].

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.

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.

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.