Public Program Reform

This study illustrates why issuing pension obligation bonds (POBs) to refinance $360 million of the MBTA Retirement Fund’s (MBTARF’s) $1.3 billion unfunded pension liability would only compound the T’s already serious financial risks.

Significant administrative failings involving the Registry of Motor Vehicles have drawn attention to an entity called the Merit Rating Board (MRB or the Board). MRB’s administrative personnel and processes have been the subject of sharp criticism, and also extensive ongoing reform efforts. This policy brief reviews the relevant circumstances, and makes recommendations for consideration by MRB and other government personnel as they move forward.

This report finds that Massachusetts' enhanced eligibility verification has allowed MassHealth, the Commonwealth’s Medicaid program, to save significant resources that could be redirected to the care of truly needy Medicaid recipients.

Regardless of what happens in the debate over repealing and replacing the ACA in D.C., Massachusetts has to tackle health care costs intelligently. We need to do more than provide insurance; we need to increase access to care. That means thinking seriously about the role of private market insurers, insurance regulations and the regulation of medical providers.

Regardless of what takes place at a national level, Massachusetts has its own set of challenges to continue pursuing the state’s commitment to universal coverage at affordable prices. This report offers a ten-point program that the state should vigorously focus on in the days ahead.

Preliminary results suggest that a new program that gives opioid overdose patients at Beth Israel Deaconess Hospital-Plymouth (BID-Plymouth) multiple opportunities to access detox programs, psychological counseling, anti-abuse drugs and other services is proving effective at reducing recidivism and returning opioid users to more productive lives.

State officials knew that development of a federal Affordable Care Act (ACA) website was off track for more than a year before the October 1, 2013 launch date.  Instead of raising concerns about the project, they misled the public by minimizing the shortcomings of the contractor hired to build the website, asked state workers to approve shoddy work and appear to have covered up the project’s abysmal progress in a presentation to federal officials.

Healthcare must remain a top policy priority for the next administration. It consumes nearly half of the state budget, has been a "pac-man" eating up resources for every other public policy priority, and has been an important driver of legislative discussions around tax increase proposals. The current path is unsustainable.

This paper will discuss the importance of secure medical records in health information exchanges (HIEs), the general history of EHRs in the US and in Massachusetts particularly, the history of privacy rights in the medical field, and finally efforts being taken to ensure more protected and private EHRs.

A First Step Toward Retiree Healthcare Reform, But Much More is Needed was provided in October 2013.