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The Blue Cross Blue Shield of Massachusetts Foundation has awarded more than $575,000 in grants to four Massachusetts organizations to conduct policy research projects focused on health care costs in the Commonwealth.

Moderating the growth of health care spending is critical to sustaining the gains that Massachusetts has made in access to care and insurance coverage since 2006. Each of the projects will contribute vital data and analysis to fill knowledge gaps around health care spending and identify opportunities for cost savings in the state. The research will provide timely guidance to Massachusetts public policymakers, payers, and provider organizations as they look to develop, expand, and improve their cost containment efforts.

Cost containment is a national issue, yet significant responsibility for identifying and implementing cost saving opportunities is expected to continue to fall to the states. With the passage of Chapter 224 of the Acts of 2012, which sets statewide health care cost growth targets, Massachusetts has the opportunity to lead in these efforts. The Blue Cross Blue Shield of Massachusetts Foundation is one of the few funders tackling this important issue.

“We know there are tremendous opportunities for making health care more efficient and affordable in Massachusetts,” said Celeste Lee, Interim President of the Blue Cross Blue Shield of Massachusetts Foundation. “These grants will help health care leaders understand, at a more actionable level of detail, some of the best opportunities for reducing spending while maintaining and improving health care quality and outcomes.” 

The Cost and Affordability Policy and Research Grants provide up to two years of grant support to research organizations. Using Massachusetts-specific data, the research teams are exploring a variety of topics relating to hospital readmissions; high-cost patients; opportunities for health gains and cost savings through the use of cost effectiveness research; and variations and best practices around hospital admissions originating in the emergency department. A complete listing of grantees with brief descriptions of their work appears below.

About the Blue Cross Blue Shield of Massachusetts Foundation
The mission of the Blue Cross Blue Shield of Massachusetts Foundation is to expand access to health care. It focuses on collaborating with public and private stakeholders to develop measurable and sustainable solutions that benefit uninsured, vulnerable, and low-income individuals and families in the Commonwealth.

The Foundation was established in 2001 with an endowment from Blue Cross Blue Shield of Massachusetts. It operates separately from the company and is governed by its own Board of Directors.

2013 Grants
Brief project descriptions

1. Project Co-Directors Arnold Epstein and Amy Boutwell, Harvard School of Public Health ($149,945)
In their project “Analysis of the Massachusetts All-Payer Claims Database to Describe the Epidemiology of Readmissions,” the research team will use the Massachusetts All-Payer Claims Database (APCD) to better understand patterns of hospital readmissions in Massachusetts. Most research on readmissions has been conducted using Medicare data or on data sets that describe only inpatient hospital encounters. By using the APCD, this research will shed new light on the diagnoses and patterns of care associated with readmissions in Massachusetts for all populations. This analysis could help providers develop and focus work around preventing avoidable readmissions.

2. Project Director Ashish Jha, Harvard School of Public Health ($136,580)
The research team will use the APCD in their project titled “Understanding High-Cost Patients in Massachusetts” to provide in-depth analysis of the small percentage of patients who consume a disproportionately large share of health care spending in the state. By gaining a more detailed understanding of high-cost patients—their diagnoses, co-morbidities, demographic factors, and providers—the researchers hope to help inform the development and targeting of potential cost containment policies, practices, and payment models for Massachusetts.

3. Project Director Natalia Olchanski, Tufts Medical Center ($150,000)
In their project titled “Best Opportunities for Improving Massachusetts Health within Budget Constraints,” the research team will use published cost effectiveness research and Massachusetts-specific data on current health care use to identify opportunities to reduce the use of overused low-value care and increase the use of underused high-value care.  Their simulation model will allow health care leaders to estimate total cost savings and health gains that could be achieved by reallocating resources from inefficient to efficient interventions.   

4. Project Director Jeremiah Schuur, Brigham and Women’s Hospital ($139,099)
Inpatient admissions that originate in the emergency department (ED) result in a significant portion of total health care spending each year, yet there is both wide variation in admission patterns and little understanding of best practices for post-ED care management and potential cost savings. In their project “Identifying Best Practices to Reduce Hospital Admission from the Emergency Department,” the research team will complete an in-depth study of three common conditions leading to admissions from the ED. By analyzing top-performing hospitals, the researchers will develop strategies and best practices around improving care and reducing costs.

The Blue Cross Blue Shield of Massachusetts Foundation today announced that eleven medical journalists from across the nation have been selected for the 2013 class of the Health Coverage Fellowship.

The 2013 participants include Greg Bordonaro of the Hartford Business Journal, Ibby Caputo of WGBH-Radio in Boston, Elizabeth Comeau of the Boston Globe, Dan Gorenstein of American Public Media’s Marketplace, Daniela Hernandez of Wired.com in San Francisco, Dr. Suzanne Koven of the Boston Globe and Massachusetts General Hospital, Priyanka Dayal McCluskey of the Worcester Telegram & Gazette, Kathleen McNerney of WBUR-Radio in Boston, Sarah Palermo of the Concord Monitor, Shannon Pettypiece of Bloomberg News, and Patty Wight of Maine Public Radio.

The fellowship is designed to help the media improve its coverage of critical health care issues. It does that by bringing in as speakers more than 50 top health officials, practitioners, researchers, and patients. It also brings the fellows out to watch first-hand how the system works, from walking the streets at night with mental health case workers to riding in a Medflight helicopter or spending a morning in a crowded emergency room.

The program, which is entering its twelfth year, is sponsored by the Blue Cross Blue Shield of Massachusetts Foundation, with support from the Blue Shield of California Foundation, Connecticut Health Foundation, John S. and James L. Knight Foundation, Maine Health Access Foundation, New Hampshire’s Endowment for Health, and the Universal Health Care Foundation of Connecticut.

The fellowship will run for nine days, beginning April 26. It is housed at Babson College’s Center for Executive Education in Wellesley, and is operated in collaboration with leading journalism organizations. Larry Tye, who covered health and environmental issues at the Boston Globe for 15 years, directs the program. A former Nieman Fellow and author of six books, Tye has taught journalism at Boston University, Northeastern, Tufts, and Harvard.

The fellowship will focus on a series of pressing medical issues – from implementing health care reform to curbing costs, addressing mental illness, and redressing public health threats. Attention also will be given to breakthroughs in medical treatments and innovations in the delivery of care.

The teaching will not end when fellows head back to their stations or papers. Tye, the program director, will be on call for the journalists for the full year following their nine days in Wellesley. He will help when they are stuck for ideas or whom to call on a story. He will assist in thinking out projects and carving out clearer definitions of beats. He also maintains a web site where fellows will post their stories and keep in touch.

Eighteen emerging leaders in health care access have been named to the seventh class of the Massachusetts Institute for Community Health Leadership (MICHL). MICHL is a leadership development program designed to help high potential professionals to increase their personal impact and enhance their health organization’s influence in the community and the health care system. The 18-day educational program takes place over the course of nine months, offering a highly experiential curriculum that includes classroom work, peer-to-peer exchanges and collaborative learning. During the program, students develop and implement a project that addresses a health care issue impacting low-income and vulnerable people in Massachusetts.

MICHL engages participants in:

• Exploring the leadership challenges facing health care organizations in Massachusetts;
• Identifying and building the capacities and competencies leaders will need to meet the challenges; and
• Fostering collaboration among private nonprofits, public agencies and academic institutions.

Past graduates include Lynn Bethel, Director, Office of Oral Health, Massachusetts Department of Public Health; Laura Sullivan, MD, Medical Director, Cambridge Health Alliance; Derek S. Brindisi, Director of Public Health for the City of Worcester Department of Health and Human Services; and Dr. Gary Chu, VP of Community Collaboration at New England Eye.

The 2012-2013 class includes:

• Rebecca Balder, Health Safety Net Director, Division of Health Care Finance & Policy
• Melinda Burri, Director of Operations, Windsor Street Health Center
• Paulette Renault-Caragianes, Director, City of Somerville Health Department
• Marta Chadwick, Director, Violence Intervention & Prevention Program, Brigham & Women’s Hospital
• Kevin Coughlin, Executive Director, Greater Lowell Health Alliance
• Holle Garvey, Nurse Practitioner, Sisters of Providence Health System
• Katherine Howitt, Senior Policy Analyst, Community Catalyst
• Jacqueline M. Johnson, Chief Operations Officer, Caring Health Center
• Stacey King, Director, Community Health & Wellness Program, Cambridge Public Health Department
• Joanna Kreil, Quality Initiatives Manager, Mass. League of Community Health Centers
• Nancy Mahan, Senior Vice President, Program Services, Bay Cove Human Services, Inc.
• Matthew McCall, Senior Consultant, The Home for Little Wanderers
• Anne McHugh, Director Chronic Disease Prevention & Control, Boston Public Health Commission
• Lenore Tsikitas, Health Access & Promotion Coordinator, Mass. Department of Public Health
• Rossana Valencia, Clinical Policy Analyst II, UMass Medical School
• Jennifer Valenzuela, National Director of Program, Health Leads
• Alyssa Vangeli, Policy Analyst, Health Care for All
• Cathy Wirth, Project Manager, Healthy Kids, Healthy Future

The mission of the Blue Cross Blue Shield of Massachusetts Foundation is to expand access to health care. It focuses on collaborating with public and private stakeholders to develop measurable and sustainable solutions that benefit uninsured, vulnerable, and low-income individuals and families in the Commonwealth. The Foundation was formed in 2001 with an endowment from Blue Cross Blue Shield of Massachusetts. It operates separately from the company and is governed by its own Board of Directors.

A study by a leading health care economist concludes that if health care costs in Massachusetts grow more slowly than projected, workers could pocket as much as an extra $9,200 in take-home pay between 2011 and 2019. Over the same period, Massachusetts employers could save up to $34.5 billion in premium payments and preserve an additional $4.1 billion to invest in jobs and profits — all of which would otherwise be lost to rising health care costs.