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Health Reform in Massachusetts: An Update as of Fall 2009

This report is the latest in a series by the Urban Institute analyzing the impact of the Massachusetts health reform law. Findings show that despite the state's economic recession Massachusetts has maintained record low levels of uninsured and access to needed health care has improved. Additionally, disparities in coverage and care have been eliminated or narrowed. Solid public support for the health reform law continues. This report is based on the 2009 Massachusetts Health Reform Survey (MHRS), which has tracked the impact of the law annually since 2006.

The Impacts of Health Reform for Women in Massachusetts

This policy brief based on data from the 2009 Massachusetts Health Reform Survey shows that women have achieved significant gains in insurance coverage and in access and use of health care since health reform was implemented in Massachusetts. The gains were particularly strong for subgroups of women who had lower levels of coverage and poorer access prior to reform, including lower-income women, women of minority race/ethnicity, and women without dependent children.

Global Payments to Improve Quality and Efficiency in Medicaid

MassHealth, the Massachusetts Medicaid program, could play a leading role in implementing dramatic changes to the health care payment system. This report outlines how so-called global payments could be used in MassHealth, which provides insurance coverage to roughly 1.2 million people in the state. Global payments have been recommended by both the Special Commission on Health System Payment and the Massachusetts Health Care Quality and Cost Council as a means of reigning in health care cost increases and improving care coordination.

Medicaid Prescription Drug Quality and Cost Management: Options, Opportunities and Progress

On November 13, 2009, MMPI partnered with the Massachusetts Health Policy Forum and Community Catalyst to sponsor a forum exploring efforts in Massachusetts to improve quality and control Medicaid prescription drug costs. At the forum, an issue brief was released that detailed implementation of a preferred drug list in the MassHealth program. In addition, speakers talked about the array of tools available to states to improve prescribing and reduce cost growth.

Accessing Children's Mental Health Services in Massachusetts: Workforce Capacity Assessment

This report is based on a survey of 1,982 mental health providers in Massachusetts including psychiatrists, psychiatric clinical nurse specialists, psychologists, social workers, mental health counselors, and marriage and family therapists. It estimates the need for childrens mental health services; assesses child and family mental health service delivery capacity; identifies variation in capacity, including variation by geography, linguistic ability, and cultural competence; and documents challenges to meeting current demand for services.

Who Seeks Emergency Care And Why?: Data From Massachusetts

This policy brief based on data from the 2008 Massachusetts Health Reform Survey shows that while health reform in Massachusetts has succeeded in increasing health insurance coverage and access to care, use of emergency departments by working-age residents remains high. Those seeking care in EDs 5/have trouble accessing care in other settings. They are less likely to use a doctors office or private clinic as their usual source of care and they are somewhat less likely to report having a place they usually go to (other than the ED) when they are sick or need advice about their health.

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.

Shared Responsibility, Government, Business, and Individuals: Who Pays What for Health Reform?

This report is the first assessment of how spending to insure hundreds of thousands of additional people in the Commonwealth is being shared. It finds that the overall distribution of spending on health insurance by employers, individuals, and government remained essentially the same between 2005, one year before passage of the 2006 Massachusetts health reform law, and 2007, one year into the laws implementation.

The MassHealth Waiver: 2009-2011 ... and Beyond

On December 22, 2008, the Centers for Medicare and Medicaid Services approved Massachusetts' request to renew the MassHealth Section 1115 Research and Demonstration Waiver (Waiver) for an additional three years, through the end of state fiscal year 2011. The Waiver, which has been in place since 1997, authorizes critical federal funding for several health coverage programs for low-income individuals and for the Commonwealth's safety net health system for uninsured residents. It is the programmatic and financial underpinning of the state's health care reform law.

Health Reform: Lessons from the Massachusetts Experience

This report summarizes the impact of health reform thus far and may be used as a point of reference for policy makers who are considering approaches to health reform elsewhere at either the state or national level. If the Massachusetts model continues to work, all or part of this model and its supporting principles may be useful in local or national health reform efforts.