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Massachusetts’ landmark health reform law, enacted in 2006, expanded coverage for the uninsured and helps to control costs, improve quality and ensure that publicly funded health care costs are adequately reimbursed.
- As of August 2008, some 439,000 people are newly enrolled in health insurance, which covers the cost of their medical care and helps them avoid the potential for medical bankruptcy in the event they become seriously ill, and offers access to preventive care to enable them to stay healthy.
- Nearly half of the new people with coverage got health insurance without the benefit of any government subsidy.
- The percent of employers offering health insurance has grown even though there are more publicly subsidized health insurance options than before.
- Partners is working closely with the Massachusetts League of Community Health Centers and other policy advocates to ensure that health care reform works for everyone and that newly insured patients have real access to primary care. Beginning with a $5 million commitment from Bank of America, and an FY08 state budget commitment of $1.7 million as the first year of a planned three-year $5 million match for the bank’s commitment, Massachusetts has embarked on a substantial effort to increase primary care capacity in community health centers through an education loan repayment plan to expand the state’s supply of primary care physicians. Neighborhood Health Plan and the Blue Cross Blue Shield Foundation of Massachusetts have provided additional financial support. Through July 2008, 45 primary care physicians and 19 nurse practitioners have made new commitments to work in community health centers for at least
two years.
Health Reform at Partners
In 2006, the number of patients without health insurance served at Partners hospitals had nearly doubled from 21,000 in FY2002 to more than 37,000 in FY2006. In FY2007, as a consequence of health reform, that number declined nearly 14 percent to 32,000. More than 8,000 patients newly covered by Commonwealth Care health insurance were treated in Partners hospitals.
Losses from uncompensated care, while still significant, also declined. During the past year, Partners hospitals and doctors have provided approximately $121 million in uncompensated care, down nearly 12 percent from the $136 million in uncompensated care losses last year. While some of the uncompensated care loss was reimbursed through the state uncompensated care pool, there was still a net loss in FY2007 of more than $98 million for Partners doctors and hospitals.
Implementation
As the provisions of health care reform are implemented, Partners has worked to anticipate the impact of each new component on patient access and provider operations.
Community Benefit staff communicate health care reform provisions to providers and patients across the Partners system. In the past year, this has involved production of educational materials for providers and patients, as well as, establishment of an internet site for providers.
Staff led efforts to train over 150 patient financial counselors at Partners hospitals and health centers on the specifics of health care reform, equipping them to become on-site health care reform experts at their facilities. Together with hospital and health center staff, Community Benefit staff have worked to ensure a coordinated outreach strategy to inform patients about new coverage options.
In addition to communicating these changes to providers across the Partners system, Community Benefit staff work closely with state agencies to clarify the operational effects of the new policies, and serve as a resource throughout the Partners system for questions related to health care reform.
Staff are also closely monitoring the long term effects of health care reform changes, including identifying areas and finding solutions for patients who might continue to have no coverage options, for example, undocumented immigrants.
Cost Management
Partners is deeply committed to managing health care costs as part of health reform. While the primary driver of increased health care costs is medical progress, Partners is working to significantly slow cost increases. By improving management and efficiency through the systemwide use of electronic medical records and computerized order entry, managing administrative costs, managing chronic disease, and working with other employers to promote health and wellness, Partners believes that it can make progress in reducing health care costs over the next five to ten years.
Medicaid Patients
Throughout the implementation of health reform, Partners has maintained its commitment to providing care for the uninsured and for children and adults on Medicaid. In FY2007, nearly $500 million in care for more than 89,000 patients on Medicaid was provided at a loss of almost $144 million, because Medicaid reimbursement does not cover hospital, physician, and health center costs.
www.massachusettshealthreform.org
© Copyright Partners HealthCare System, Inc.
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