A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

One-Two From Patrick Adminstration

One-Two From Patrick Adminstration

January 26, 2012

This week the Patrick administration reaffirmed its commitment to health care in the Commonwealth. First, the Governor's State of the Commonwealth speech focused on payment and delivery system reforms that will stem the rising costs of health care:

The market is moving in the right direction and that’s very good news. But it is not enough. Too many small businesses and too many working families still go through an annual ritual that starts with notice of another premium increase, and too often ends with a new plan costing the same or more for less coverage. Slowing the rate of increase is critical, but unless that slowdown is sustained, health care costs will continue to squeeze everything else – including job growth itself. We need to put an end to the “fee-for-service” model. We need to stop paying for the amount of care, and start paying instead for the quality of care. We need to empower doctors to coordinate patient care and to focus on wellness rather than sickness. And we need medical malpractice reform. All of this is addressed in the bill I filed last year. ... The Legislature has done considerable work on our proposed reforms, and I want to congratulate your care and thoughtfulness. Now it’s time to act. Before you take up next year’s budget, pass health care cost containment legislation. This is another hard decision. But for the good of the Commonwealth, let’s do this and do it now.

Over the last year and half our Campaign for Better Care has been meeting with legislators, presenting all around the state, and offer public comments regarding the issues of payment and delivery reform. We emphasized that curbing costs must be tied to measures that improve the quality of care and protect the vulnerable as we redesign care. We must make a serious and robust investment in public health and prevention. We need to ensure transparency in all aspects of the health system. The savings must accrue to us, so patients can reap the benefit of a less costly system. The Campaign for Better Care has offered specific legislative ideas (pdf) around each our patient-centered principles. If you would like to get involved with the Campaign please contact Paul Williams at pwilliams@hcfama.org. Second, yesterday's release of the proposed budget for fiscal year 2013 makes progress on health care coverage, public health, and cost control. While $545 million in MassHealth savings are imposed, the budget assumes no further cuts to MassHealth benefits. The administration's has posted write-up of their health cost and their public health initiatives on the state's site. As ususal, the Mass Budget and Policy Center put out their flash analysis last night, with more detailed analysis to come. The budget proposal fully funds Massachusetts health reform programs, including the re-integration of some 37,000 legal immigrants into the Commonwealth Care program. Full coverage for this group was required by a decision of the Massachusetts Supreme Judicial Court earlier this month, in a case brought by HCFA affiliate Health Law Advocates. The budget makes major progress in reducing costs through improvements in overall health and wellness. HCFA strongly endorses the proposed increase in the tobacco tax, and the ending of the loophole that exempts sugary soda and candy from the sales tax. These revenue sources will both improve overall health and provide needed funds for health programs. HCFA also supports the expansion of tobacco cessation benefits to Commonwealth Care, as called for in legislation HCFA has actively supported. The budget includes over $5 million desperately needed by MassHealth to improve customer service and begin implementation of national health reform. Service has deteriorated dramatically as cutbacks have reduced staffing at enrollment centers. Funds are also provided to implement a modern on-line integrated eligibility system for all health programs, scheduled to roll out in 2014. HCFA calls on the legislature to reverse a budget cut that substantially reduced dental benefits to adults in the MassHealth program. Good oral health is a requirement for good overall health, and we know that the reduction in dental benefits will lead to higher long-term costs. Truly the Commonwealth can afford to end the inexcusable pain and suffering affecting thousands caused by lack of dental care. We'll of course have more to say as the budget process continues. -Paul Williams, Ana Aguilera and Brian Rosman