Consumer Driven Health Care: A New Agenda for Cost Control in Massachusetts

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This paper provides a discussion of CDHC, what it is and how it can help constrain health care costs and increase patient engagement in Massachusetts. While supply-side approaches are also necessary for cost control, without engaged consumers, Massachusetts may find that it cannot accomplish its cost-containment goals as quickly or as successfully as desired.

Impact of the Federal Health Law’s “Cadillac Insurance Tax” in Massachusetts

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The Obama administration has done its best to highlight some of the more popular provisions of the law such as expanded preventative benefits, allowing children up to age 26 to remain on their parents insurance, closing the prescription drug “doughnut hole” for seniors on Medicare, and expanded contraception coverage. Yet, many of the less attractive provisions have not been given a local spotlight. This brief will examine the impact of the so-called “Cadillac tax” included in ObamaCare.

Innovative Medical Liability Reform

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This paper describes Massachusetts' existing medical liability system, including how it has failed to achieve its social objectives, the impact of the system on health care costs, and recent efforts towards reform. It presents policy options for medical liability reform. It examines both traditional and nontraditional avenues of reform along with strategies for advancing medical liability reform in Massachusetts.

Business Solutions to the Health Care Crunch

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While larger employers have engaged their employees in wellness initiatives and consumer-driven approaches, small employers have often lagged behind. Small businesses can, however, adopt these health benefit approaches to address their own rising health care costs.

Fixing the Massachusetts Health Exchange

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The importance of this work is especially clear as the Patient Protection and Affordable Care Act of 2010 (ACA) requires a health benefit exchange to be operating in every state by 2014. The question of the Connector's effectiveness is of critical importance to other states as they try to plan and design what an exchange will look like in their own state' For Massachusetts, the ACA provides both opportunities and challenges moving forward.

An Interim Report Card on Massachusetts Health Care Reform: Part 4

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This report is the final report in a series of four. Earlier reports in this series evaluated access to health insurance and health care, equitable and sustainable financing, and administrative efficiency. The focus of this report will be on cost-effective quality, and the analysis will be organized by the four "Scorecard Metric,' presented in Figure 1. 

An Interim Report Card on Massachusetts Health Care Reform: Part 3

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This report is the third in a series of four. The focus of this report is on administrative efficiency.

An Interim Report Card on Massachusetts Health Care Reform: Part 2

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As an alternative to analyzing the reform’s impact on isolated issues, in January 2009 the Pioneer Institute proposed a framework for evaluating the reform.

An Interim Report Card on Massachusetts Health Care Reform: Part 1

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The focus of this report is on the reduction of barriers to access.

Drawing Lessons: Different Results from State Health Insurance Exchanges

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Policymakers are considering several options for national health reform, each of which includes some form of "insurance exchange." These exchanges allow the uninsured, and employees of small to medium-sized businesses, to compare qualified health plans, purchase insurance and, if eligible, receive subsidies toward the cost of their plans.

Massachusetts Healthcare Reform: A Framework for Evaluation

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Passed in 2006, the Massachusetts healthcare reform bill represents an innovative approach to healthcare reform in the United States. The bill (Chapter 58 of the Massachusetts Laws of 2006) has four main goals: to use an individual mandate to expand access to near universal levels; to establish guidelines for employers' fair share' contribution and involvement; to reorganize insurance markets and manage the distribution and subsidization of several insurance plans through the new Massachusetts "Connector"; and to establish transparency that will aid in understanding and assessing the bill's cost and quality of care.

The Clinical Performance Improvement Initiative

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The Massachusetts Group Insurance Commission (GIC) has embarked on a groundbreaking plan to control costs, improve healthcare quality, and promote cost-efficiency. Labeled the Clinical Performance Improvement (CPI) Initiative, this multi-year effort has the potential to save the Commonwealth and its enrollees tens of millions of dollars, while improving the quality of care.

Comparing the Clinical Quality and Cost of Secondary Care in Academic Health Centers and in Community Hospitals

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This study analyzes data from hospitals in six states, including Massachusetts, to compare the cost and quality of secondary care for under-65, privately insured patients in Academic Health Centers (AHCs) and non-AHC or community hospitals.

Rationalizing Health and Human Services

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Over the course of the past decade, thousands of organizations have used business process redesign and information technology to get to know their customers well, and they have used that information to do a better job of meeting their customers’ needs. Five years ago, anyone who had a checking account, a mortgage, an auto loan, and a credit card with the same financial institution might as well have been dealing with four different companies. Today, more often than not, that individual gets one statement each month that consolidates his or her entire relationship with that financial institution. The bank knows the extent of its relationship with each customer, and its customers can manage their accounts and loans in a unified, coordinated manner.

An Economic History of Health Care in Massachusetts 1990-2000

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This paper traces the economic history of the health care system in Massachusetts from the early 1900s to the present and offers a series of recommendations that would bring to Massachusetts the advantages of a more market-based system.

Nonprofit to For Profit Conversions in Health Care: A Review

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The analysis presented in the paper suggests areas in which caution must be exercised to assure that community benefits provided by nonprofits are preserved in a post-conversion environment, and that full value is realized and appropriately redirected. Nothing in the analysis indicates that nonprofit to for-profit conversion should be barred from consideration in Massachusetts.