Ensuring Sustainable Health Reform in Massachusetts

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Ensuring SustainableHealth Reform in
Massachusetts

• May 19, 2008

Matt Fishman Partners HealthCare
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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.

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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.
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Uncompensated Care at Partners Hospitals is
Declining
Uncompensated care costs at Partners hospitals
(Brigham Womens, Faulkner, Massachusetts
General, Newton-Wellesley, and North Shore
Medical Center) have declined by 17.5 since 2005.
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Partners Patients Moving fromFree 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.
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Key Strategic Decisions (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)

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Key Strategic Decisions(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.

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Current and Upcoming Challenges(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

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Current and Upcoming Challenges(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

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Assets

• 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