Browse by Structural Racism and Racial Inequities in Health

Achieving a Racially and Ethnically Equitable Health Care Delivery System in Massachusetts: A Vision, Toolkit, and Proposed Action Plan

This report proposes a statewide Health Equity Action Plan that offers an organizing structure, process, and set of practical steps for collectively achieving a racially and ethnically equitable health care delivery system in Massachusetts. The Health Equity Action Plan is accompanied by a toolkit, which includes an illustrative set of interventions and best practices that providers, health care delivery system leaders, and other stakeholders can deploy to achieve the envisioned system.

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The Time is Now: The $5.9 Billion Case for Massachusetts Health Equity Reform

Racial and ethnic disparities in health care access, quality, and outcomes have been well documented in Massachusetts and across the country. Solutions for reducing inequities in health require investments of time and resources for which there will always be competing priorities. In understanding the value of these investments, it is critical to recognize that in addition to the human toll, they represent a significant economic burden to individuals and families, health care providers, employers, public and private sector payers, and the overall Massachusetts economy.

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A Focus on Health Care: Five Key Priorities for the Next Administration

Massachusetts’ historical achievements in bold and innovative health care policy have positioned the state as a national leader in transforming health care coverage, access, affordability, and quality. Yet despite decades of progress, the COVID-19 pandemic made it impossible to ignore that not all Massachusetts residents are able to access, afford, or experience health care equally.

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Creating a Robust, Diverse, and Resilient Behavioral Health Workforce in Massachusetts

The behavioral health workforce in Massachusetts is in crisis. The COVID-19 pandemic has increased the prevalence of behavioral health issues and demand for services, exposing and aggravating the vulnerabilities of Massachusetts’ behavioral health workforce and delivery system. Health care, including behavioral health care, has been among the industries hardest hit by the “Great Resignation,” exacerbating workforce shortages that predated the pandemic.

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Impact of the American Rescue Plan Act on the Massachusetts Health Care System

In response to the health and economic damage caused by the COVID-19 pandemic, Congress passed the American Rescue Plan Act (ARPA) in March 2021, which makes $1.9 trillion available to individuals, states and territories, counties, cities, community organizations, educational institutions, and other entities. Some funds are intended to shore up or even expand programs and agencies that have been depleted during the pandemic, while other funds are designated or available to create new programs.

Cover of the ARPA Impact report
Cover of the ARPA Impact report

How are Massachusetts Community-Based Organizations Responding to the Health Care Sector’s Entry into Social Determinants of Health?

In Massachusetts, MassHealth is implementing a number of reforms as part of its most recent Medicaid 1115 demonstration waiver extension to transform the delivery of care for most members and address the social determinants of health (SDOH). In light of the new interface between health care and social service delivery fostered by the MassHealth program redesign, it is important to understand how community-based organizations (CBOs) perceive the entry of health care organizations into their domains of social service delivery.

Partnerships for Health: Lessons for Bridging Community-Based Organizations and Health Care Organizations

Given the impact that social factors have on health status and expenditures, and the shift toward value-based payment models that reward providers based on outcomes, health care organizations (HCO) and community-based organizations (CBO) across the country are increasingly working together to address patients’ social needs.

Community Matters: Exploring the Link Between Community Characteristics and Uninsurance in Massachusetts

Despite the near-universal health insurance coverage that the state has maintained for nearly a decade, pockets of high uninsurance remain for both adults and children in communities across Massachusetts. This brief, prepared by the Urban Institute, explores the relationship between community characteristics and the uninsured rate for people of all ages in Massachusetts and highlights the geographic and community context of the remaining uninsured. It also provides data to better target outreach and enrollment activities.

Health Care and Social Service Spending and Outcomes: How Does Massachusetts Compare with Other States?

International comparisons of industrialized countries show that those with a higher ratio of social service spending relative to health care spending have better health outcomes. This finding is consistent with decades of research underscoring the importance of social, behavioral, and environmental factors on health outcomes.

Leveraging the Social Determinants of Health: What Works?

Social determinants of health, which encompass social, behavioral and environmental influences on one’s health, have taken center stage in recent health policy discussions. While research indicates that greater attention to these non-medical factors may improve health outcomes and reduce health care costs, translating this evidence into actionable recommendations for policy makers and others has been challenging.

Closing the Gap on Racial and Ethnic Health Care Disparities: Lessons Learned from 2005-2008 Grantees

In 2005, the Foundation launched the Closing the Gap on Racial and Ethnic Health Care Disparities grantmaking area and secured the Disparities Solution Center at Massachusetts General Hospital as an evaluation partner. This report highlights stories of change from policy, organizational, provider, and client perspectives. Lessons from this report guided the Foundation in revising its funding strategy for the subsequent 2008–2011 grantmaking cycle.

Access to and Affordability of Care in Massachusetts as of Fall 2008: Geographic and Racial/Ethnic Differences (Revised)

This policy brief by Sharon Long of The Urban Institute measures geographic and racial disparities in access to health care in Massachusetts. The data in the brief comes from the third annual Massachusetts Health Reform Survey. This revised version of the policy brief, which was originally published 5/28/2009, reflects changes made after an error in constructing survey weights was discovered and corrected.

Pay-for-Performance to Reduce Racial and Ethnic Disparities in Health Care in the Massachusetts Medicaid Program

The 2006 Massachusetts health care reform law included a provision to make Medicaid hospital rate increases contingent upon quality measures, including measures of the reduction of racial and ethnic disparities. To date, no other pay-for-performance programs have incorporated measures of the reduction of racial and ethnic disparities into their incentives. MMPI organized the Massachusetts Medicaid Disparities Policy Roundtable to bring together a group of experts to develop and recommend an approach to implementing the program.