April 2011

April 30, 2011

Restore Essential Dental Benefits for Mass Residents

Oral health is full body health. So, why would Massachusetts – the state that pioneered universal healthcare for all residents – slash dental benefits for those that need it most? The answer is easy, budget cuts. Well, that had HCFA seeing RED. We are going to take action and we need your help! Please plan to join HCFA, dental students, patient advocates and those affected by the cuts at the statehouse next Tuesday May 3rd at 10 am to make sure that policy makers Restore Essential Dental Benefits to Massachusetts Residents. To ensure that we are seen and heard, we are asking all of those who attend the event to “wear RED to restore” in support of this event.

We want you to join us in supporting An Act to Restore MassHealth Adult Dental Benefits (S. 1079/H .1529). If enacted, the bill would restore the $56 million in MassHealth dental coverage cuts that went into effect last June 30 as part of the fiscal year 2011 budget.

Restoring Essential Dental Benefits to Massachusetts Residents will help hundreds of thousands of people in the Commonwealth maintain adequate oral healthcare. One of those people who will be helped is a woman named AnnaMae. Last year, AnnaMae went to her doctor with a toothache. She was sent home with pain medication and told to see a dentist. When AnnaMae went to the dentist, she was told that she would need to have three teeth pulled. But just days after her visit to the dentist, she received a notice saying that funding for MassHealth adult dental benefits had been slashed. So, in the course of a week, AnnaMae had three teeth extracted as well as invasive moldings, oral surgery and fittings. Unfortunately, the moldings for her teeth were made before MassHealth received her dentists' claims so she still has gaps in her mouth where her teeth were pulled. Annamae said “our state is paying thousands more each year to care for health issues that could have been staved off if people like myself had access to comprehensive dental care - which addresses oral issues before they become whole health issues."

Oral health is full body health, so let’s not let budget cuts hinder our states overall health.

Please join AnnaMae, HCFA, the Oral Health Advocacy Taskforce and other supporters to Restore Essential Dental Benefits to Massachusetts Residents next Tuesday May, 3rd at 1pm at the statehouse…and of course, remember to “wear RED to restore.” Let’s make them see R.E.D. on Tuesday!

For details, download our flyer (pdf) or contact Courtney Chelo at cchelo@hcfama.org.

April 29, 2011
Headline: Sen. Brown Hail GOP Plan to Cut Medicaid Spending

Senator Brown should know that the "GOP Plan to Cut Medicaid Spending" is a dagger aimed right at Massachusetts.

Here's our analysis from a few weeks ago:

Deep cuts would be made to both the Medicaid funds Massachusetts is expecting over the next decade, and to funding provided to the state under health reform. Combined, the loss over 10 years would be a staggering $44.5 billion.

Here’s the year-by-year breakdown of federal funds lost to Massachusetts compared to current projections (notice the millions change to billions):

2012: $53 million

2013: $436 million

2014: $2.15 billion

2015: $3.45 billion

2016: $4.47 billion

2017-2021: on average, 6.8 billion/year

These sums are hard to imagine in human terms. Let’s help. The $436 million the Commonwealth would lose in 2013 is enough funds to fully cover over 120,000 children. The $2.15 billion the state would lose in 2014 could cover around 190,000 disabled seniors. If the $4.47 billion the state would lose in 2016 were taken out of Medicaid, it would lead to the loss of over 75,000 jobs, as our economy contracts due to the loss of federal funds.

Let Senator Brown know what you think.

-Brian Rosman

April 29, 2011

Did members of the House of Representatives think no one would notice when they vote to repeal a popular law?

The reaction to the House vote to repeal the 2008 law banning most gifts to prescribers from drug and device makers has been fast and furious, and must be causing a lot of after-the-fact discomfort among many members.

Item One: AARP, the largest membership organization in the state, went back to their candidate questionnaire from last year and found out something very interesting. Fourteen state reps who had promised to support the gift ban broke their promise and voted to repeal the law they had pledged to uphold. AARP sent a letter to each of the switch hitters, asking why they went back on their word. This got picked up by the Globe, and the CommonHealth blog, under the title, "AARP Outs Lawmakers Who Broke Pledge On Gift Ban."

Item Two: WBUR's Radio Boston show started reaching out to all the members who reversed their votes from the previous year. Would anyone take their bait and talk? The finally got veteran Rep. James Miceli, (D-Wilmington) to come on their show. He was refreshingly blunt and honest, saying it was the restaurant industry's lobbying effort that made the difference:

We had tremendous lobbying up here at the State House by the restaurant association and some of the other folks who are affected by this. They say they were affected in a very aggressive manner. Business was off tremendously, since we put the prohibition on pharmaceutical companies wining and dining doctors and spending money in that arena.

More pressure will certainly be placed on those who were for the bill before they were against it.

Item three: Of course, that "tremendous lobbying" effort by the restaurant industry was built on completely fraudulent claims, that the law somehow hurts the restaurant industry. A copy of the industry's lobbying missive got picked up by the CommonHealth blog, and we supplied the facts to rebut the claims:

1. Claim: “Restaurants provide an important setting for all types of meetings to take place and shouldn’t be excluded as a venue from hosting educational meetings and presentations.”

Truth: The statement is false, and restaurants are not excluded by law. The law allows “educational meetings” at restaurants, as long as the doctor pays his or her own way. If these sessions are for the benefit of the physicians, why can’t the doctor pay for the meal, and listen to the educational presentation from the drug company? Why do premium payers have to cover the meal?

2. Claim: “The mislabeled ‘gift ban’ has been devastating to restaurants and thousands of middle-class employees.”

Truth: The statement is false. State figures conclusively show that the restaurant industry has been booming. Last year was their best year ever, and so far this year is topping last. Devastating? There’s no evidence of that. In any case, every dollar spent on drug industry marketing on restaurant meals is a dollar added to the cost of health care in America. So why should our health care dollars prop up restaurant meals for well-to-do physicians?

The state meals tax receipts leave no doubt that the restaurant industry is booming in Massachusetts. As we said before, 2010 was their best year ever, and sales for the first 3 months of 2011 are up 4% compared to the comparable time last year.

Item Four: The blogs that cover this issue are having a field day, with lots of sarcasm flowing. Author and national drug expert Dr. Daniel Carlat waxed sympathetic:

Yes, commoners escape workplace demands by going home at 5 or by taking a stroll through a park during lunch. But doctors need raw oysters and wine after a hard day of work—plenty of it, free, and with fawning pharmaceutical reps complimenting them on their knowledge of vintages

Blogger Jim Edwards on the CBS business network titled his comment, Massachusetts Votes to Legalize Drug Company Kickbacks to Doctors. He wrote that the vote "isn’t just about the bizarre way the restaurant industry seems to control healthcare policy in the Bay State. It’s about ending a laudable experiment in transparency, and cloaking the way pharmaceutical companies give money and gifts to doctors in order to boost prescription sales.... The Massachusetts politicians who voted to repeal the gift ban say this is all about helping the state’s catering-services-industrial-complex, but the real benefit will go to companies who want to obscure the way kickbacks lubricate the drug business."

April 28, 2011

Last night, the House voted in favor of the consolidated Health & Human Services amendment, which included $25 million for Commonwealth Care Bridge, the health coverage program for legal immigrants who were denied Commonwealth Care coverage beginning in the summer of 2009. This funding will allow the program to continue for the first six months of Fiscal Year 2012, with the possibility of additional funding to fund Bridge through the second half of the fiscal year.

Thank you to Representatives Cabral and Toomey for their leadership on this issue, and to Representatives Balser, Basile, Brady, Brownsberger, Canavan, Coakley-Rivera, Devers, Forry, Fox, Henriquez, Khan, Malia, O’Day, Provost, Rushing , Sanchez, Sannicandro, Sciortino, Smizik, and Straus for their support.

April 28, 2011

[Note: this is a guest post by Jessica R. Hamilton, Co-Founder and Co-Chair of Boston Young Healthcare Professionals & former HCFA staffer]

We all know Massachusetts is a state of innovation and firsts. But nothing tops our state’s list of firsts more than the gains we’ve made in access to health care. There’s a real health care movement in Massachusetts, and more importantly, there's a commitment to working together to figure out the ins and outs of our health care system. We have nationally recognized professionals leading our work, but there’s also an untapped group of young, dedicated professionals ready to roll up their sleeves and contribute to the work being done here. However, from where I sit, there’s very little recognition of this group.

Let me tell you a little more about myself. In 2008, almost fresh out of college, I found myself thrown into the middle of the Massachusetts health care scene when I accepted a position as a policy associate with Health Care For All (HCFA). I had not a clue what I was getting myself into, but I knew I was committed to building a career in health care policy here in Massachusetts and that was the beauty of it. However, outside of my talented staff, I didn’t know anyone else my age who knew what I meant when I talked about medical loss ratio, data-mining, or the social determinants of health. I began to feel like that dorky cousin you don’t invite out to public events. Personally, I craved the opportunity to meet my counterparts working in state or local government, health insurance, pharma/biotech, hospitals and so on, but had no clue how to make that happen. It wasn’t until after I left HCFA to pursue other interests in health care that I learned two things: 1) I have a lot more to learn about health care and 2) I need to build relationships with my unknown counterparts in other health care disciplines to make that happen.

Last spring, I met a young woman asking the same questions I had and off of her idea to create a forum to connect young professionals like us, Boston Young Healthcare Professionals (BYHP) (www.byhp.org), was born. The purpose of BYHP is to connect emerging and passionate healthcare leaders in the greater Boston area to foster strong relationships and build knowledge across all healthcare disciplines. By providing members and the larger healthcare community with educational, professional development, networking, and civic engagement opportunities and events, BYHP will serve as a forum for young professionals across all healthcare disciplines to collaborate, share knowledge and experiences, and grow their careers.

Our organization officially launches tonight (Thursday) at 6:30pm in Cambridge. Details and RSVP info are here. We have great speakers lined up to talk about the importance of cross-sector relationships and developing young professionals: a seasoned healthcare professional and member of our Advisory Board and the writers of WBUR’s CommonHealth blog.

To date, more than 350 professionals have registered to attend our event which goes to show you that BYHP could very well be the next movement in Massachusetts health care. We hope you’ll get involved and need you – your time, energy and ideas, too. There are endless opportunities for young professionals, employers, seasoned professionals, and health care stakeholders to get involved in BYHP. Will you join us?

For more information about BYHP, please visit www.byhp.org. You can you also join our LinkedIn group, follow us on Twitter or email us at info@byhp.org.

April 27, 2011

Some items from day 2 of the House budget debate and votes on amendments:

Dental Students Lobby For MassHealth Dental Benefits 4-26-11Good News: A strong group of dental students and advocates gathered this afternoon at the State House to speak up for oral health. In just under two hours they were able to visit the office of every Representative to urge them to support Amendment #203. The amendment, filed by Representative Scibak, seeks to restore MassHealth adult dental benefits for some of the most vulnerable residents of the Commonwealth. Don’t forget to call your Representative today (look up the number here) to remind them that oral health IS health, and that MassHealth adult dental benefits need to be restored.

Bad News: Like last year, the House voted 128-22 to repeal the drug and device marketing restrictions law (see Globe coverage). Just hours after the House leadership announced their desire to keep substantive legislation out of the budget, the House adopted a non-budgetary provision repealing an entire section of the General Laws. The proposal had not been considered by any Committee, nor had an open public hearing for public comment and debate.

During the debate, pharma's supporters dragged out the same already-refuted arguments they always use. They kvetched about the restaurant industry, despite the highest ever state meals tax receipts, indicating a health restaurant economy. The talked about canceled conventions and biotech jobs. Yet, as Rep. Jason Lewis put it in the debate, "More than 30 biotech companies created more than 800 new jobs in Massachusetts last year along. There has been no – that I’m aware of – no discernable drop in revenue to the commonwealth as a result of the gift ban. The demand for the convention center is growing."

In fact, as we pointed out, Medical Meeting magazine reported that "the actual fallout out [of the gifts law] has been about nil. No meetings were pulled out of Boston because of the new law."

Our partner AARP, the largest membership organization in the state, put out a statement that was exactly on point:

"AARP is dismayed by the House's action today to repeal the state's prescription drug company gift ban, which restricts drug company marketing practices, like free lunches for doctors, that drive up prescription prices for consumers. ... Bottom line: The cost of free lunches and other perks for prescribers should not be footed by consumers who are struggling to afford their medication. AARP will fight to keep the gift ban on the books, and to bring down the high cost of prescription drugs. We urge the Senate to do the right thing, and protect the prescription drug company gift ban."

We will be fighting aggressively in the Senate to prevent this backwards step from making it to the Governor's desk.

Good News: The House approved a consolidated public health amendment that restores some of the deep cuts made in vital public health programs. The $8.95 million amendment includes an additional $2.4 million for early intervention programs, $2.5 million more for for HIV/AIDS services, and an additional $335,000 for smoking cessation. We're particularly pleased that the additional $2 million for health promotion and disease prevention adds language funding the Betsy Lehman Center for Patient Safety. The amendment also doubles substance abuse step-down services funding to $4.8 million, and adds an additional $500,000 for the Women, Infant and Children’s nutritional services.

More health-related amendments should come up over the next few days. Please call your Rep!
-Brian Rosman

April 26, 2011

The new Director of the Bureau of Health Care Safety and Quality, Dr. Madeleine Biondolillo, is stepping into her new role today. Dr. Alice Bonner, the previous Director, left in February to take a position at the Centers for Medicare and Medicaid Services. Dr. Biondolillo has a background in geriatric and long-term care having most recently been the Corporate Medical Director at Radius Management Services, a long-term care company. She has also been the Executive Director of Urban Medical Group, a physician group which provides care to underserved populations, and she has worked in home-based rehabilitation services as well.

Dr. Biondolillo wrote a column that appeared in the Globe in January about the care her mother received when hospitalized and the lack of coordination and communication among the health care providers. She touts payment reform as a way to move the system towards the coordination and integration of care that is so sorely needed.

We welcome Dr. Biondolillo to her new position and we look forward to working together to improve the quality and coordination of care for all residents of Massachusetts. And a thank you to Elizabeth Daake for serving as interim director for the past couple of months.
-Deborah W. Wachenheim

April 25, 2011

In order to make informed health care decisions patients and consumers need access to reliable information. While many consumers turn to the internet for answers to their health questions, it can be difficult to know which websites to trust. Connect to Research is free online resource for consumers to obtain accurate, thorough and up-to-date health information from trustworthy local health experts.

Massachusetts residents are fortunate to live in the hub of world-class health institutions. Patients from all over the world travel here to receive care, at the same time groundbreaking medical research and thousands of local scientific studies are conducted by area health professionals. Consumers now can take advantage of our state's high-quality health information through a single gateway: Community Connect to Research.

The site features free articles written by experts at Harvard Health Publications on 120 of today's most important health conditions. The site also boasts a carefully chosen collection of links to more online medical resources developed by hospitals and health centers affiliated with four of the state's top universities, including Boston University, Harvard, Tufts, and UMass.

In the coming months, Health Care For All will bring you updates on Community Connect to Research’s work with clinical trials and research. Stay tuned for more!

Click here to read more about Community Connect to Research.

April 25, 2011

In order to make informed health care decisions patients and consumers need access to reliable information. While many consumers turn to the internet for answers to their health questions, it can be difficult to know which websites to trust. Connect to Research is free online resource for consumers to obtain accurate, thorough and up-to-date health information from trustworthy local health experts.

Massachusetts residents are fortunate to live in the hub of world-class health institutions. Patients from all over the world travel here to receive care, at the same time groundbreaking medical research and thousands of local scientific studies are conducted by area health professionals. Consumers now can take advantage of our state's high-quality health information through a single gateway: Community Connect to Research.

The site features free articles written by experts at Harvard Health Publications on 120 of today's most important health conditions. The site also boasts a carefully chosen collection of links to more online medical resources developed by hospitals and health centers affiliated with four of the state's top universities, including Boston University, Harvard, Tufts, and UMass.

Click here to read more about Community Connect to Research.

April 25, 2011

Where in the state were our community organizers?

Whole Body! Whole Budget!
It’s about that time of year again—flowers are blooming, days are getting longer, and health activists are donning their armor and preparing their testimonies to bring to budget hearings next month. This week, Ari and I spent our time with leading activists to envision a health system that works for all consumers—not just those who can afford it. In Everett, Anna May Taylor made it clear that cutting adult dental benefits right after her three teeth were pulled was probably not the best thing for her health and her nutrition. In South Boston, Eris Burton described how she avoided insulin shots through healthy living, and how her new habits are now trickling down to her grandchildren. And in Dorchester, Boston University students filmed Steven Lezama explain how he went from a blood sugar level of 600 to 170 by eating healthily, taking his medicine on time, and working weekly with his community health worker. Consumers are in gear to protect their whole health through saving some of the crucial services that are being slashed in the budget!

Meanwhile, leaders in Lynn are brainstorming ways to get started to bring down health care costs in their community through prevention and quality, coordinated care.

Want to jump in? Contact Ari Fertig (afertig@hcfama.org) and Celia Segel (csegel@hcfama.org).

-Celia Segel

April 25, 2011

If it’s the week after April school vacation, then this is the week for the Massachusetts House to consider amendments to its version of the budget for the next fiscal year (resources: comprehensive House budget summary from Mass Budget and Policy Center and summary of the health provisions (pdf) from Mass Medicaid Policy Institute). The budget debate is expected to take all week, and most years the health-related amendments don’t come up until near the end of the debate.

The loss of federal stimulus aid and the ramp-up of the recovery will result in a $1.9 billion gap next year between expected revenue and costs. With new revenues ruled off the table, the House Ways and Means proposal relies on budget cuts to close this gap. For health care, MassBudget calculates that overall health spending will be down 3.7%, around $547 million, compared to last year. The House proposal spends about $70 million less than the Governor recommended.

The result is drastic, painful cuts.

The most dramatic cut is the elimination of the Commonwealth Care Bridge program. If this were to stand, some 20,000 legal immigrants would lose their coverage. Eliminating coverage to these Bay Staters would be a dramatic step back from the gains of health reform. Eliminating coverage just shifts costs to the unmanaged Health Safety Net program, already severely underfund. We strongly oppose this cut, and HCFA and the ACT!! Coalition is supporting amendment 750, filed by Representative Toomey, to continue the program.

We’re also actively working on the following key amendments (the text of all amendments is here):

  • Adult dental services: Last year MassHealth eliminated many dental services for adults. Amendment 203 (Scibak) would start restoring full dental benefits to particularly vulnerable groups, including pregnant women, people with developmental disabilities, or those with HIV/AIDS. Amendments 345 (Scibak), 107 (Wolf) would also make progress in restoring some or all of the adult dental services eliminated last year. The mouth is an integral part of the body, and reducing dental benefits leads to increased long-term health costs.
  • Public Health: Adequate investments in public health leads to improved overall health and decreased future costs. HCFA strongly supports amendments 224 (Schmid), which restores some funding for health promotion and disease prevention, amendment 373 (Malia), which supports substance abuse and recovery follow-up programs, amendment 611 (Kafka), to prevent deep cuts to cost-effective early intervention services for children, and amendment 712 (Provost), which provides some minimal funding for health care quality efforts and the Office of Patient Protection.
  • Prescription Drugs: HCFA supports amendment 205 (Lewis), which prevents the elimination of the successful Academic Detailing program that provides objective education to counter biased marketing from the pharma industry. We also oppose a number of amendments that would reverse our gains by opening up avenues for cost-increasing marketing ploys by pharma, including amendments 16 (Jones), 230 (Bradley), and 471 (Michlewitz).
  • Improve Health Reform: Amendment 268 (Holmes) reduces the costly in-and-out churn among families on MassHealth by allowing for 12 months of ongoing assistance, and amendment 744 (Cariddi) funds the MassHealth Outreach and Access to Care grants, critical to keeping people covered.
  • Health Equity: Amendment 429 (Rushing) allows funds to go for the operation of the Office of Health Equity within EOHHS.

In addition to these, a number of amendments have been filed to move all MassHealth members to managed care organizations. These amendments ignore the fact the MassHealth is in the process of seeking more active care management of members in the Primary Care Clinician plan. We believe this process ought to be allowed to work before dramatic changes are made to the structure of MassHealth.

Call your Representative. Contact your Representative now on these important amendments. A phone call is best - the House switchboard is at 617-722-2000.
-Brian Rosman and Courtney Mulroy

April 22, 2011

The House budget debate starts up next Monday. We'll be posting our detailed take on the proposed amendments (there are 758! - list here) soon, but in the meantime the Massachusetts Medicaid Policy Institute (MMPI) has published an overview of the health provisions, produced by the Massachusetts Budget and Policy Center in partnership with the Massachusetts Law Reform Institute.

The 3-page report is here (pdf), and it includes a wealth of detail on the assumptions and cuts included in the House Ways and Means proposal, which will be the starting place for the debate next week. Bottom lines from MMPI:

Key differences between the HWM budget proposal and the Governor's budget proposal include:

  • HWM discontinues funding for CommonwealthCareBridge, which provides subsidized coverage to 20,000 legal immigrants;
  • HWM includes $32.4 million less in programmatic funds for the MassHealth program as well as proposes even greater cuts to the MassHealth administrative budget than those proposed in the Governor's budget; and,
  • HWM designates $4 million to support the Division of Health Care Finance and Policy in its efforts to create further transparency of health care cost information through its creation of an All Payer Claims Database.

MMPI will be publishing budget fact sheets at each stage in the FY 2012 budget process, as budget proposals move through the legislature. This is a very important contribution to the public understanding of the health care issues to be decided in the budget process.
-Brian Rosman