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.
Problem Management Plus: An Evidence-Based Approach to Expanding Access to Community-Based Mental Health Supports
Problem Management Plus (PM+) is a proven, scalable, and cost-effective low-intensity mental health intervention that can be delivered by trained non-clinical workers for people who are experiencing common mental health conditions, such as anxiety or depression, or stressful life problems. PM+ fills a gap in the behavioral health services system by providing early intervention and potential prevention of more acute behavioral health service needs.
Massachusetts has been exemplary in developing health insurance coverage policies to cover its residents. By 2019, the state’s uninsurance rate was 3.0 percent, the lowest rate in the nation, representing about 204,000 uninsured residents. While the state’s overall uninsured rate at a given point in time is low, more than twice as many people - 503,000, or 7.3 percent of the population - experienced a gap in coverage over the previous twelve months. And importantly, not all groups benefit equally.
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.
Massachusetts administers much of MassHealth through an 1115 Demonstration waiver, approved by the Centers for Medicare and Medicaid Services (CMS), which it has extended several times since it was originally approved in 1995. In December 2021, Massachusetts submitted a request to CMS to extend its Demonstration for another five years.
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.
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.
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.
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.
From 2008 through 2011, the Foundation supported 11 community-based coalitions across Massachusetts through its Closing the Gap on Health Care Disparities Initiative. This report, prepared by Mary Coonan and Terry Saunders Lane of The Center for Social Policy, University of Massachusetts Boston, explores areas of coalition development, system change, and public awareness.
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.
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.
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.