The Massachusetts Medical Society has published two papers on risk adjustment:
The papers provide an overview of risk adjustment and where it fits in health reform while offering practical suggestions for using risk adjustment in Massachusetts.
A new video examines key actuarial and operational considerations for state health insurance exchanges. The video includes perspectives from the CFO of the Massachusetts Health Connector and from several actuaries.
We’ve blogged before about the effort to ensure young Americans have health insurance, looking to the passage of Michelle’s Law in 2008, which extends coverage to college students. (And, tangentially related, we have offered analysis of the efforts to provide “young invincible” coverage.)
Now Massachussets is considering a bill that would tax universities $1 per day for any students who lack health insurance.
A Medicaid program in Massachusetts has spurred a 26% reduction in smoking rates, and has prevented various hospitalizations and care associated with asthma, heart attacks, and other conditions. See more here.
Smoking cessation programs are an example of a wellness benefit that demonstrably works.
We’ve talked before about changing the expectations in how we pay for healthcare. Here are some ideas coming out of Massachusetts. One of many efforts in play to bend the cost curve.
As the reform conversation intensifies, people are looking for lessons from various state efforts to reform their respective healthcare systems. The Chicago Tribune ran an article today comparing the Federal effort with reform attempts in Wisconsin. In March, Health Affairs looked to draw lessons from California’s attempts at reform. And of course Massachusetts is instructive.
Massachusetts is in the news a lot these days when it comes to healthcare. One effort that is flying under the radar for now but may yield some interesting results has to do with the effort to analyze and publish reliable, state-wide data on cost and quality. Milliman is working with Massachusetts Health Quality Partners on this effort.
Massachusetts has been getting a lot of healthcare reform ink, and Kevin Sack penned another article on the topic recently in the New York Times. The attention makes sense given the ambitious universal coverage experiment at work in Massachusetts. But is the media overlooking other instructional examples from elsewhere in the country? Vermont has something interesting going on as well.
We’ll posit several states that deserve consideration based on recent Milliman research:
Electronic Health Records, Long Term Care, Reform, Universal coverage
The New York Times reported today about the growing cost problem in Massachusetts as the commonwealth looks to rein in the expense of their universal healthcare program. Milliman principal Cathy Murphy-Barron discusses the cost challenges posed by healthcare reform in an article published in November.
Of particular interest is the Massachusetts plan to use prevention and other value-based measures to fight costs. Quoting the Times article:
They want a new payment method that rewards prevention and the effective control of chronic disease, instead of the current system, which pays according to the quantity of care provided. By late spring, the commission is expected to recommend such a system to the legislature.
This sounds reasonable, and most people can agree on the need for preventive care; many believe the fee-for-service payment system is flawed. But will a commitment to prevention result in savings? Cathy addresses this point in her article:
Wellness. Disease management. Consumer-driven health plans. Value-based insurance design. There has been no lack of effort on the part of the healthcare and insurance industries in recent years to tackle the problem of spiraling costs, and the work to date holds much promise. Yet every time we look at these innovations, we find ourselves unsure of the one thing we most want to know—their effect on cost. Most innovations show at least modest potential for cost savings but the long-term effect on costs is not yet clear.
Time will certainly tell whether what the Times calls ” perhaps the boldest state health care experiment in American history” will have as much early success tackling the cost problem as it has had tackling the access problem.
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