A Healthy Blog

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

Health Care Market

Faces of MassHealth: Portrait of a Diverse Population

MassHealth – the state’s combined Medicaid and Children’s Health Insurance Program (CHIP) – is a cornerstone of the Massachusetts health coverage system, providing coverage of medical, behavioral health and community-based services for 1.8 million low-income Massachusetts residents. MassHealth enrollees are often characterized by a narrow set of baseline statistics; however, MassHealth enrollees represent a diverse range of life experiences and health care needs. Read more »

New Open Enrollment Period Explained

We have blogged several times about the new open enrollment period that has been created for individuals who buy private health insurance coverage for themselves individually or for their families.  We have created a flow chart that explains the new law.  It is quite technical and full of legal terms.  If you have any questions, please contact our HelpLine at  1-800-272-4232. - Jekkie Kim Read more »

UPDATED: Governor Patrick Talks Payment Reform: "The next big frontier is payment reform"

UPDATE: In his inaugural speech, the Governor was clear about his vision of health care cost control and payment reform: We can’t be satisfied until health care is as affordable as it is accessible. That means creating incentives for all providers to work together to deliver better care at lower cost, improving transparency in the charges for services, reforming the medical malpractice system, and getting excessive paperwork out of the way of the relationship between doctor and patient. It means a new emphasis on wellness and prevention. Read more »

DOI's MLR Turn

The Division of Insurance held a hearing this morning on the definition of “medical loss ratio” under Massachusetts law. The DOI released an emergency regulation on October 1st. Medical loss ratio (or MLR) is the percentage of an insurance premium that is spent on medical-related expenses, as contrasted with administrative expenses and profits. Massachusetts’ small group health insurance cost containment law, Chapter 288, requires carriers to spend at least 88 percent of each premium dollar on medical-related expenses next year and 90 percent in subsequent years. Carriers who don't meet... Read more »

Caritas Sale Closes

Seven months after they initially shook hands, Caritas Christi Health Care, the state's second largest hospital chain, officially closed its sale to an affiliate of Cerberus Capital Management, a New York private equity firm. The deal culminates a four-year odyssey for Caritas to find a buyer to financially support its operations. While much discussion and energy has been put into the deal’s structure and financing, how the new owners business plan as a for-profit hospital plays out over the next three to five years will tell if for consumers, this was the right deal to make. The Caritas... Read more »

Happiest Place on Earth Report (Updated)

Georgia Maheras, HCFA's Private Market Policy Manager, is in Orlando this week as a consumer representative at the National Association of Insurance Commissioners fall meeting. She's one of 28 designated consumer voices, competing with thousands of insurance industry lobbyists for the ears of the 50 state insurance commissioners. Massachusetts Insurance Commissioner Joseph Murphy is in attendance. NAIC normally stays out of the headlines. But the ACA gives NAIC first crack at recommending the arcane details that determine the reach of the Medical Loss Ratio (MLR) rules. Georgia wrote about... Read more »

DPH Approves Caritas Transfer

The Department of Public Health’s Public Health Council today put its stamp of approval on the transfer of the six Caritas Christi hospitals to Steward Health Care. Approval of the deal by the Massachusetts Supreme Judicial Court, which is expected next week, will finalize the conversion of these Catholic owned hospitals to for-profit businesses run by Steward. The PHC confirmed the conditions placed on the deal by Attorney General Martha Coakley and also added its own conditions to ensure the hospitals provide interpreter services for its patients. Read more »

AG Mandates Consumer Protections in Sale of Caritas

Seven months ago, when the proposed sale of the Caritas Christi hospital network to Cerberus Capital Management was announced, many were concerned about how Cerberus, a Wall Street private equity firm with no experience running a hospital, would manage the state’s second-largest hospital network. Read more »

Harvard Pilgrim Drops a Medicare Plan, NOT Due To Health Reform

There was lots of national attention on Harvard Pilgrim's announcement last week that it was dropping its Medicare Advantage plan. As noted by Maggie Mahar on the Century Foundation's blog, the anti-Obama crowd leapt up to declare this as another sign of the evil of "Obamacare." Here are some of the articles Mahar found: Read more »

What Will Happen if Cerberus’s Gamble Goes Bust?

Last Sunday's Boston Globe lead editorial echoes many of the concerns of consumers across the Commonwealth who are questioning the proposed sale of the Caritas Christi hospital chain to the Wall Street private equity firm Cerberus. While acknowledging that the proposal “sounds good” and would bring capital and jobs to the state, The Globe raises a number of questions that need to be answered before the state moves ahead with the largest conversion of a non-profit hospital chain to a for-profit business in the state’s history. Read more »


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