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.

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.

This collection of materials is the latest in a series by the Urban Institute summarizing the findings from the 2018 Massachusetts Health Reform Survey (MHRS). The Foundation began conducting the MHRS in fall 2006 to support the evaluation of Massachusetts’ 2006 health care reform bill. The survey has been fielded periodically since 2006 – most recently in spring 2018 – to monitor key measures pertaining to health insurance coverage and health care access and affordability among non-elderly adults (ages 19-64) in Massachusetts. For the first time in 2018, the MHRS included several questions pertaining to access to care for mental health (MH) and substance use disorder (SUD) services.

The 2018 MHRS highlights the state’s ongoing success at maintaining near-universal health insurance coverage since the passage of Massachusetts’ 2006 health care reform law. However, the survey’s core measures demonstrate that opportunities for improvements in access to and affordability of health care for the state’s residents remain and the new questions on MH/SUDs highlight the significant barriers to care and gaps in access to care faced by those seeking MH/SUD services. 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 adults and their families, particularly for the most vulnerable.

Findings from the 2018 MHRS were featured at a Foundation event held on December 11, 2018. Click here to learn more about the event.

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

This series of reports describes the results of a comprehensive mixed-methods study, Access to Outpatient Mental Health Services in Massachusetts. The study sought to quantify the wait times for outpatient mental health office visits in Massachusetts, better understand the experiences of clients seeking an appointment, and identify facilitators and barriers to accessing mental health services. Study findings are based on primary data from multiple sources, including qualitative data from stakeholder interviews and client focus groups and quantitative data from surveys of clinicians and administrators at organizations providing outpatient mental health services.

Findings from this study were featured at a Foundation event held on October 31, 2017. Click here to learn more about the event.

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 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.

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.

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.

Affordability Still a Challenge

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 annually since 2006. This round of the survey, which was fielded in the fall of 2013, was jointly funded by the Blue Cross Blue Shield of Massachusetts Foundation and the Robert Wood Johnson Foundation. These results provide a means for continuing to monitor the efforts in Massachusetts to sustain the coverage gains achieved through the 2006 health reform law. In addition, the 2013 MHRS provides a new baseline for assessing the impacts of the state's efforts to improve the affordability of care and reduce health care spending because it coincides with the first full year under the provisions of Chapter 224 of 2012 and precedes the roll-out of major changes under the Affordable Care Act (ACA) that began in January 2014. Findings show that while Massachusetts has maintained high levels of health insurance coverage and health care use, the cost of care continues to remain a significant burden, especially for low- and middle-income individuals and families.

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

• A five-page summary report;
• A full narrative report;
• A chart pack;
• A methodology report and a copy of the survey instrument.

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 and the Robert Wood Johnson Foundation will be making available a public use file of the 2013 surveys as they did with the previous years' surveys (i.e., 2006 - 2010, 2012). The 2012 public use files will be available through the Inter-University Consortium for Political and Social Research.

Affordability Gap Remains Despite Coverage Gains

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 since 2006. This round of the survey, which was fielded in the fall of 2012, was jointly funded by the Robert Wood Johnson Foundation and the Blue Cross Blue Shield of Massachusetts Foundation. These results provide both a means for continuing to monitor the efforts in Massachusetts to sustain the coverage gains achieved through the 2006 health reform law and an important new baseline against which to assess the impact of the state’s efforts to improve the affordability of care and reduce health care spending. Findings show that while coverage and access to care remain strong in Massachusetts, health care costs continue to be a burden for many individuals and families.  

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

• a five page summary, including comparing Massachusetts to the nation
• a series of infographics focused on the following topics: coverage, changing patterns of care, medical debt;
• a policy brief analyzing the impact of health care costs in depth;
• a full report; and,
• a chart pack.

For those interested in learning more about the methodology of the survey, please see this report and this survey instrument tool.

The Blue Cross Blue Shield of Massachusetts Foundation and the Robert Wood Johnson Foundation will be making the complete survey results for all six years of the survey available for public use through the Inter-university Consortium for Political and Social Research.

Findings from the survey were featured at a Foundation event on March 26, 2014. See materials from the event located here.

This chartpack summarizes the impact of the 2006 Massachusetts health reform law. The chartpack gathers data from surveys and analyses by state government agencies including the Massachusetts Center for Health Information and Analysis, the Massachusetts Department of Revenue, and the Massachusetts Health Insurance Connector Authority, as well as highlights from health reform tracking surveys conducted by the Urban Institute. 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 chartpack regularly.

This report is the latest in a series by the Urban Institute analyzing the impact of the Massachusetts health reform law based on the Massachusetts Health Reform Survey (MHRS).  Findings show that that the remaining uninsured are disproportionately young, male, Hispanic, and non-citizens.  The data presented also show the geographic areas of the state with high numbers of uninsured children and non-elderly adults. Suggested outreach strategies to reach the remaining uninsured include targeting specific populations of uninsured individuals as well as specific geographic areas with higher rates and numbers of uninsured. Click here to view a one-page graphic with key findings from the report.

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.

This report is the latest in a series by the Urban Institute analyzing the impact of the Massachusetts health reform law. Findings show that despite the state's economic recession Massachusetts has maintained record low levels of uninsured and access to needed health care has improved. This report is based on the 2010 Massachusetts Health Reform Survey (MHRS), which has tracked the impact of the law annually since 2006.

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.

This report is the latest in a series by the Urban Institute analyzing the impact of the Massachusetts health reform law. Findings show that despite the state's economic recession Massachusetts has maintained record low levels of uninsured and access to needed health care has improved. Additionally, disparities in coverage and care have been eliminated or narrowed. Solid public support for the health reform law continues. This report is based on the 2009 Massachusetts Health Reform Survey (MHRS), which has tracked the impact of the law annually since 2006.

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 report is based on a survey of 1,982 mental health providers in Massachusetts including psychiatrists, psychiatric clinical nurse specialists, psychologists, social workers, mental health counselors, and marriage and family therapists. It estimates the need for childrens mental health services; assesses child and family mental health service delivery capacity; identifies variation in capacity, including variation by geography, linguistic ability, and cultural competence; and documents challenges to meeting current demand for services.

This policy brief based on data from the 2008 Massachusetts Health Reform Survey shows that while health reform in Massachusetts has succeeded in increasing health insurance coverage and access to care, use of emergency departments by working-age residents remains high. Those seeking care in EDs 5/have trouble accessing care in other settings. They are less likely to use a doctors office or private clinic as their usual source of care and they are somewhat less likely to report having a place they usually go to (other than the ED) when they are sick or need advice about their health. And frequent users of emergency rooms (those reporting more than three ED visits in a year) are a sicker, more disabled and chronically ill population than other adults in the state.

A 10-page issue brief that assesses the extent to which the insurance provided in Massachusetts under health reform in 2007 protects individuals from financial risk in the event of a major illness or injury.