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.
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.
In December 2021, Governor Baker signed Chapter 102 of the Acts of 2021 into law. This legislation, often referred to as the “ARPA bill,” appropriates close to $4 billion, including $2.55 billion in funding directly from the federal American Rescue Plan Act (ARPA). ARPA was passed in March 2021 to provide money to states to start recovering from the effects of the COVID-19 pandemic. Chapter 102 invests money from ARPA in many areas, including housing, infrastructure, education, and economic development.
The goal of this study was to better understand whether Primary Care Providers (PCPs) identify a need for a PCP-to-behavioral health (BH) provider consultation program for adult patients with mental health conditions and substance use disorders (SUDs), and whether they would utilize such a program. Additionally, the study sought to understand the type of BH conditions providers encounter, the proportion of adult primary care patients with BH needs, and the challenges PCPs face in supporting adult patients with BH conditions.
Behavioral Health During the First Year of the COVID-19 Pandemic: An Update on Need and Access in Massachusetts 2020/2021
This brief provides an updated snapshot of the need for behavioral health care and experiences accessing it in the Commonwealth as of 2020/2021, based on a new survey commissioned by the Foundation. This survey was fielded by NORC at the University of Chicago between December 2020 and March 2021 and gathered information on the need for and access to behavioral health care among Massachusetts adults ages 19 and older and their close relatives.
Racism and Racial Inequities in Health: A Data-Informed Primer on Health Disparities in Massachusetts
This primer serves as a foundational resource to broaden the collective understanding of racial and ethnic health inequities and disparities in the Commonwealth as part of our new focus area of Structural Racism and Racial Inequities in Health.
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.
Addressing timely access to behavioral health care through the adoption of open access methods supports the well-being of people with behavioral health conditions, improves staff productivity, and increases financial stability for provider organizations. However, no study has previously documented the experience of provider organizations using this model in Massachusetts.
This five-part series of issue briefs describes MassHealth’s impact on the health and finances of its members, families, and communities, as well as on the wide variety of stakeholders and sectors outside of the traditional health care realm that benefit from the program, including:
Behavioral health urgent care services are a critical component of the broader behavioral health care delivery system. Developing and sustaining a robust set of behavioral health urgent care services across community-based settings will provide adults with more options for timely access to care and offer alternatives to emergency departments for treatment.
Expanding Access to Behavioral Health Care in Massachusetts through Telehealth: Sustaining Progress Post-Pandemic
At the onset of the COVID-19 public health emergency, Massachusetts led the nation in rapidly deploying progressive policies to temporarily expand access to telehealth. These changes have enabled significant increases in adoption of telehealth, including telebehavioral health, for providers and consumers in a short period of time. Prior to COVID-19, utilization of telebehavioral health had not gained widespread spread traction in Massachusetts despite its potential as a means to dramatically improve access to behavioral health care services, particularly for vulnerable populations.
On October 18, 2019, Governor Charlie Baker submitted House Bill 4134, An Act to Improve Health Care by Investing in Value, to the Massachusetts Legislature. The bill proposes a comprehensive set of policies designed to address barriers to behavioral health care access, including the establishment of a new system that would incentivize providers and health plans to spend more of their funds on primary care and behavioral health services while rebalancing spending in other areas.
Fostering Effective Integration of Behavioral Health and Primary Care in Massachusetts: An Evaluation
In January 2016, the Blue Cross Blue Shield of Massachusetts Foundation undertook a three-year grant-funded initiative to expand access to integrated behavioral health (IBH) and primary care services in Massachusetts – Fostering Effective Integration (FEI). Grants were awarded to a diverse cohort of eight providers in the Commonwealth with experience in delivering IBH care. This report describes the findings of an evaluation conducted by John Snow, Inc. (JSI) from January 2016 to December 2018.
This report and companion chart pack document and describe the current behavioral health (inclusive of mental health and substance use disorder) care system for children, adolescents, and adults in Massachusetts; outline a new whole-person-oriented vision for behavioral health care in the Commonwealth; and propose a strategic approach and series of recommendations through which the state can advance this vision to achieve reform.
This collection of materials is the latest in a series by the Urban Institute summarizing the findings from the 2018 Massachusetts Health Reform Survey (MHRS). The Foundation began conducting the MHRS in fall 2006 to support the evaluation of Massachusetts’ 2006 health care reform bill. The survey has been fielded periodically since 2006 – most recently in spring 2018 – to monitor key measures pertaining to health insurance coverage and health care access and affordability among non-elderly adults (ages 19-64) in Massachusetts.
This series of reports describes the results of a comprehensive mixed-methods study, Access to Outpatient Mental Health Services in Massachusetts. The study sought to quantify the wait times for outpatient mental health office visits in Massachusetts, better understand the experiences of clients seeking an appointment, and identify facilitators and barriers to accessing mental health services.
This primer is designed to increase understanding of the behavioral health care system in Massachusetts and the issues affecting access to care for individuals with mental health and substance use disorders. It is intended to serve as a foundation for future work focused on behavioral health system solutions.
Estimating Cost Reductions Associated with the Community Support Program for People Experiencing Chronic Homelessness
This report presents the results of a study analyzing the impact of the Community Support Program for People Experiencing Chronic Homelessness (CSPECH) on the utilization and cost of health care services. CSPECH is an innovative program through which MassHealth reimburses community-based support services provided to chronically homeless individuals residing in permanent supportive housing.
Fostering Effective Integration of Behavioral Health and Primary Care in Massachusetts, Year One Report
This report includes findings from the evaluation of the 2015 Fostering Effective Integration grant program. The goals of the evaluation were to determine 1) how grantees defined “success” for their integration efforts, 2) grantee perceptions of the critical components of effective integration programs, 3) common barriers to integration, and 4) measures grantees used to assess programs.
Coordinating Care for Patients with Alcohol or Drug Use Disorders: Effective Practices and Common Barriers in Three Centers
In recent years, integrating treatment for mental health and substance use disorders (SUD) with primary care has been the subject of extensive research testing a number of different integration models and specific interventions. While many of these approaches have shown promise in demonstrations or clinical trials, the true test of value is in real-world settings where there are competing demands on scarce resources, strict fidelity to intervention protocols is difficult, and patients have multiple urgent needs.