THE PIONEER BLOG

Patrick Admin’s Misdiagnosis on ACA Transparency

This post was co-written by Michael Morisy. During this year’s budget debate, Pioneer asked many questions about the reality behind optimistic health care cost predictions which, if flawed, could leave the state facing a $900 million budget hole next year alone. The passage of the Patient Protection and Affordable Care Act (PPACA) could make things even worse down the line – if it survives judicial challenges. But as much as we’d like to share the state’s optimism, we have had an incredibly hard time getting answers to some basic questions about the underlying assumptions that the state may have about future health care costs. Back on April 9, we requested documents from the Massachusetts Health Connector that discuss the financial […]

Silliness Buried In the Casino Bill

The coming casino debate has a whiff of anticlimax, as it appears that passage is all but assured, given the lack of elected opposition. However, there’s one detail of the bill that cries out for correction. As a principle, the bill calls for a referendum to be held in each potential host community for a casino. Solid reasoning, right? Except, buried deep in the fine print, is an exemption for communities greater than 125,000 in population. In those communities, only the ward with the potential site needs to vote its approval in an election. The impact of this provision sets a separate standard for Boston, Springfield, and Worcester from the other 348 municipalities in the state. In Boston, wards vary […]

What We Learned From Sal DiMasi

Barring a successful (or incredibly lengthy) appeal, Sal DiMasi will spend the next 8 years in jail. It’s a jarring sentence that will consume almost half of his expected remaining years. For many of his former colleagues, this should be sobering news. There have been a string of scandals facing politicians in state government. For the most part, these have resulted in relatively short jail terms, if any. DiMasi’s sentence will likely be viewed differently — its longer and he was no ordinary legislator. DiMasi was, at least on a dissenting vote basis, the most powerful speaker in recent memory. He managed to get resoundingly reelected as Speaker despite ethics questions hanging over his head. Even after the trial, sitting […]

Are ACOs designed to care for grandparents also good for their grandkids?

This op-ed ran in the Boston Business Journal Friday September 2, 2011. Boston’s Children’s Hospital was recently recognized as the nation’s top hospital for children by U.S. News and World Report. But what will Obamacare and Gov. Patrick’s “Phase II” state health reform, which move the health industry toward so-called accountable care organizations (ACOs) and alternative payment methods, have on world-class medical facilities like Children’s? An ACO is a network of doctors and hospitals that share responsibility for patient care. In theory, it’s like purchasing a car from a dealership; instead of buying each part yourself, an ACO brings together the different parts of patient care and ensures that the pieces work well together. Yet the reality isn’t so simple. […]

Boston’s Advanced Work Class Maze

In Boston, school starts tomorrow (except for K1 and K2, which starts on Monday). For those newcomers to the Boston Public Schools, congratulations, you’ve survived the much-feared school lottery (see previous comments here, here, here, and here.) Many lottery survivors are again tested by the Advanced Work Class “AWC”) program. 3rd grade students are tested and those scoring highly enough are invited to participate in Advanced Work Class, described as “an accelerated academic curriculum for highly motivated and academically capable students” by the district. These classes are viewed as the gateway to the prestigious exam schools and there’s clearly a link. About half the exam school students come from the public school (a surprisingly low number, in my view), and […]

Does Your Doctor Know How Much That Costs?

A local group  (run by a former classmate of mine) is accepting entries for an annual contest that highlights stories of medical costs gone wild. The group Costs of Care’s mission is that:  All doctors should understand how the decisions they make impact what patients pay. The prompts for the contest stress the importance of all stakeholders being more aware of the impact of decisions that we make in receiving our health care. Do you have a story about a medical bill that was higher than you expected it to be? Or a time when you wanted to know how much a medical test or treatment might cost? How about a time you figured out a way to save money […]

Let Walmart In!

Opposing Wal-Mart seems to be in vogue these days. Mayor Curtatone of Somerville is doing it, so is Mayor Menino. Menino, along with many community leaders, is opposing the expansion of Wal-Mart into Dudley Square. Their opposition is built on two objections – that Wal-Mart will damage the existing retail infrastructure in Dudley Square and that Wal-Mart is bad corporate citizen. But it’s a short-sighted attempt by government actors to tilt the playing field in favor of certain businesses. For one, the mega-marts are already here. The city has one – the Target in the South Bay Shopping Center (and Target’s masterful branding as the ‘good citizen’ compared to Wal-Mart is a whole separate story). But if you look at […]

Obama Admin Rethinking Massachusetts Model?

The summer has led to little news from the Legislature and Governor Patrick on the health policy front. Which, on the first day of September, left me to wonder whatever happened to the temporarily extended Massachusetts MassHealth 1115 waiver? Simply put, this waiver from the federal government allowed the 2006 health reform to become a reality. The waiver was last renegotiated by the Patrick Administration in 2008, and was extended until June 30, 2011. Quietly this summer, that deadline was pushed back twice, and was set to expire yesterday. I have just learned that the waiver was extended for another 30 days. So I am left to ask–what is the issue(s) holding up a longer term renewal? In a summer […]

The 28X Debacle: A Missed Opportunity in Transportation

What’s the 28X? It was the MBTA’s attempt to put a version of bus rapid transit on the existing 28 bus line. Route 28X would have converted portions of the bus route, particularly on Blue Hill Avenue, into a dedicated bus lane. It would have implemented many of the principles of bus rapid transit, like the dedicated lane and more widely spaced station stops, to allow faster service and greater throughput for one of the system’s most heavily used bus lines. And it would have done it with the help of federal funds and at an incremental cost to the existing system (as opposed to a large greenfield capital expense). As this space has noted before, there’s no money out […]

Parent Power

(image from DropOutNation.net) Used to be that Massachusetts was the epicenter of most of the innovations occurring in education. We had the best standards in the nation. The best student tests, best teacher tests, a standout accountability office, the most advanced charter approval process and one of the most knowledgeable charter office staffs. We had a progressive funding formula that ensures a level of equity in what gets spent on children. As of 2014, we’ll have whittled that list down to the best teacher test in the nation (if it survives) and a progressive funding formula. Massachusetts is no longer mentioned, whispered or even thought of as a national leader for its recent laws and policies. Compare Massachusetts’ agenda of […]

In Praise of the Indigo Line

This space generally takes a dim view of several MBTA expansion projects, but there is one we can get behind — the Indigo Line. What’s that? Its the MBTA’s expansion of the low volume (~1600 passengers per day) Fairmount Line to create more stations and improve the existing ones. The Fairmount Line is unique in the MBTA’s commuter rail network — its starts and terminates in Boston (South Station – Readville) and only has five stations. Officially known as the Fairmount Line Improvement Plan, the project will add four stations to the line. So what’s good about that? First, it will provide rail access to a dense urban population center that is currently dependent on slower buses. Take a look […]

Mr. Secretary, Open this Road!

Summer travels have taken me up and down the East Coast, and I continue to marvel at other states’ ability to implement open-road tolling, while Massachusetts continues to hem, haw, and plan pilot programs. I’ve seen the results of open road tolling in New Hampshire, New Jersey, and Delaware, and they are impressive. Drivers used to congestion and bottlenecks now proceed at regular speed. If congestion was an important measure of performance for MassDOT (and I respectfully suggest its not, as they don’t measure it in their performance reports), open road tolling would be a priority project. As transponders drop in price, they will become more pervasive (despite some objections) and the utility of open-road tolling will only increase. Also, […]

Will Massachusetts’ Evergreen Solar secrets die with it?

Now that Evergreen Solar is filing for bankruptcy, the question of why Massachusetts ever thought the failing solar upstart was a good investment – and why the state should be in risky green energy investing at all – seems a pretty pertinent one. Unfortunately, some state agencies seem determined to make sure whatever lessons could be learned from the disaster won’t see the light of day. In particular, the Executive Office of Housing and Economic Development has dragged its feet an inexcusably long time for getting even basic information on the background of the $58 million in investments, incentives and aid. On March 10, 2011, I filed a series of three public records requests with that agency requesting: Documents that analyze potential […]

Lurking Over the Horizon

As the summer slumber descends on Beacon Hill, where sub-10 minute legislative sessions with just a handful of attendees is currently the norm, a September wake-up call awaits. Former Speaker Sal DiMasi, who was reelected to that post with 135 votes out of a possible 160 despite ongoing ethics violations, is due to be sentenced on September 8th. The prosecution is currently seeking 12.5 to 15.5 years for DiMasi’s sentence, a pretty serious number when you consider that he’s 65 years old. In the background of this case lurk the sentences given to Diane Wilkerson and Chuck Turner, who got 3.5 years and 3 years respectively for lesser offenses than DiMasi. Many observers will be watching to see if DiMasi’s […]

What if Bill Gates rewarded results?

Last winter, two things clarified my views on the utility of the Gates Foundation in education policy. One was an opportunity I had to spend time at the Samuel Roberts Noble Foundation, an Oklahoma-based foundation that focuses primarily on plant and seed sciences. Their campus was intensely focused on experimentation and rewarding results in the field. Its buildings were not ostentatious but rather highly focused on their mission. They were also interested in investing in high-value ROI obtained from places like the Jonas Salk Institute for Biological Studies in California. The other came in Sam Dillon’s December 2010 New York Times article on the Gates Foundation’s effort to scope out the perfect way to evaluate teachers. Using value-added statistical models, […]