Ensuring sustainable health reform in massachusetts
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Ensuring Sustainable Health Reform in Massachusetts. May 19, 2008. Matt Fishman Partners HealthCare. Key Ingredients in Continued Success. Strong operational and administrative elements in place

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Ensuring sustainable health reform in massachusetts

Ensuring SustainableHealth Reform in Massachusetts

May 19, 2008

Matt Fishman

Partners HealthCare


Key ingredients in continued success
Key Ingredients in Continued Success

  • Strong operational and administrative elements in place

  • Strong commitment and leadership from Senator Kennedy, Governor Patrick, House Speaker DiMasi, Senate President Murray

  • Other indicators of success:

    • Insurance coverage is up

    • Demand on uncompensated care pool is down

    • Employers are maintaining their commitment to coverage

    • Individual mandate is in effect

  • Broad-based coalition that can identify options and solutions

  • Strong focus on making this legislation work on the ground.


Bank of America and Commonwealth of MA medical and nursing school loan repayment Year 1 results:47 primary care providers (35 MDs and 12 NPs) have committed to practice in community health centers, providing access for more than 84,000 newly insured patients.


Uncompensated care at partners hospitals is declining
Uncompensated Care at Partners Hospitals is Declining school loan repayment Year 1 results:

Uncompensated care costs at Partners hospitals (Brigham & Women’s, Faulkner, Massachusetts General, Newton-Wellesley, and North Shore Medical Center) have declined by 17.5% since 2005.


Partners patients moving from free care to commonwealth care
Partners Patients Moving from school loan repayment Year 1 results:Free Care to Commonwealth Care

10/1/07 Free Care Eligibility Change

* Effective 10/1/07, those eligible for Commonwealth Care could no longer choose to remain on Free Care. These patients will eventually become self pay patients unless they enrolled in Commonwealth Care.


Key strategic decisions 1 of 2
Key Strategic Decisions school loan repayment Year 1 results:(1 of 2)

  • Focused on coverage first

    • Common ground for all stakeholders – agreed that it was the first step to take.

    • Shared responsibility as key principle.

  • Developed a comprehensive plan that many constituencies could agree on

    • Did not look at reform elements in isolation – instead, took a comprehensive approach

      • Coverage

      • Financing

      • Insurance market reform

      • Cost & quality (initial steps only)


Key strategic decisions 2 of 2
Key Strategic Decisions school loan repayment Year 1 results:(2 of 2)

  • Have continued to actively engage constituencies throughout implementation

    • Issue advertising and polling

    • Developing the first affordability schedule and minimum creditable coverage definitions.

    • Business-organized educational meetings on legislation

  • Ongoing working sessions on shared responsibility and other issues.


Current and upcoming challenges 1 of 2
Current and Upcoming Challenges school loan repayment Year 1 results:(1 of 2)

  • State financial commitment

  • Tracking the number of uninsured

  • Recent and pending adjustments: increased consumer cost-sharing, proposed tobacco tax increase

  • Covering those left out

  • 3 year §1115 waiver extension


Current and upcoming challenges 2 of 2
Current and Upcoming Challenges school loan repayment Year 1 results:(2 of 2)

  • Health system cost containment

    • Several cost management proposals under consideration in legislature

      • HCFA, MAHP, Murray; House expected in June

    • Brandeis cost management seminars

    • Healthy Mass. Compact

    • RAND study

    • Quality & Cost Council

    • Possibility of business-led coalition


Assets
Assets school loan repayment Year 1 results:

  • Strong engagement from political leaders

  • Broad-based coalition that can identify options and solutions

  • Strength of implementation effort to date

  • Intellectual capital

  • Recognition of need for action on costs

  • Strong network of community health centers


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