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First in Massachusetts What We Learned About Health Care Reform and Our Members That Could Help You
| Date post: | 17-Dec-2014 |
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First in Massachusetts
What We Learned About Health Care Reform and Our Members
That Could Help You
The Political Landscape After Universal Access• 2006: Access addressed; costs not addressed
(Chapter 58)• 2008: Anything and everything to do about costs:
The anticipated and the unanticipated (Chapter 305)
• 2010: Rate regulation (Chapter 288)• The Attorney General’s report• Medicare payment updates• Debt ceiling problem
Research and Process
• Comprehensive research: physician workforce, access to care, quality and the practice environment– Did not address the important issue of cost of care
• Feedback gathered from physicians on practice issues and patient concerns (surveys and interviews)
• Leadership forums with national experts ( e.g. Elliott Fisher, MD)
• Frequent discussions with MMS leadership and key stakeholder decision makers about universal access to care
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 201160.0
70.0
80.0
90.0
100.0
110.0
100.0
102.2100.9
98.396.3
94.5
92.191.0
86.4
83.9
80.8
78.476.5 76.4
74.6 75.374.2 73.5 72.8
100.0101.4
100.4101.8 101.1
99.3
92.991.6
88.7
85.984.3
81.7
78.977.8 77.0 77.6 77.8 77.9 77.6
MA INDEX
U.S INDEX
MMS Physician Practice Environment Index
MMS 2011 Physician Workforce Study
• Recruitment and retention of physicians in the state remain difficult – 55% of physicians had difficulty filling vacancies– 52% believe the pool of applicants is inadequate – 44% say time to recruit has increased– 38% reported retention becoming more difficult
• For the first time in the 10 years of the study, as many physicians are as satisfied (42.3%) with the practice environment in Massachusetts as are dissatisfied (42.3%)
Dermatology SevereFamily Medicine Severe General Surgery Severe
Internal Medicine CriticalNeurosurgery SevereOrthopedics SeverePsychiatry Critical
Urology Critical
Average New Patient Wait Time (days)
24
17
26
29
34
36
53
24
26
28
36
41
43
48
Pediatrics
Orthopedic Surgery
Cardiology
Family Medicine
OB/GYN
Gastroenterology
Internal Medicine
2011 2010
Accepting New Patients
46%
51%
80%
88%
88%
90%
95%
47%
49%
73%
82%
85%
95%
97%
Family Medicine
Internal Medicine
Pediatrics
Cardiology
OB/GYN
Gastroenterology
Orthopedic Surgery
2011 2010
MMS 2011 Physician Workforce Study
Internal Processes
• Task Force on Health Reform– 2005 to the present– Universal Coverage
to Cost Drivers
Internal Processes
• Task force principles– Support for universal insurance coverage– Support for individual and employer mandates– Bi-modal approach to expand public and private payer
responsibilities
• MMS served on state commissions• MMS leadership met with legislators &
administration
Internal Processes
• State asks MMS to gather physician feedback: focus groups on payment reform/global budgets
• One size doesn’t fit all• Voluntary participation
– Infrastructure support– Proper risk adjustment– Patient expectations– Patient incentives– Malpractice reform
– Transparency– Risk management skills– Good data from the payers– Anti-trust reform– Culture and leadership
Health Reform ContinuesWith the Focus on Costs• New commission on payment disparities• MMS asked to again hold focus groups with
physicians for solutions• MMS educational forums address cost of care• ACO Solution Center
– MMS creates new center to support physicians regarding the changing paradigm in health care reform
Getting the Word Out
Key Audiences
LegislatorsPersuade
MembersEducate
Our Membership
PCPsLoved It
SpecialistsNot so much
The Road Show
• Why it’s important• Share research • What it could mean
to them• The political realities
Key Driver: Private Sector Costs
100
150
200
250
300
350
400
450
500
550
600
Per Capita Health Expenditures Per Capita GDP
Average Wage and Salary CPI Boston
Per Capita MA Health
Expenditures:550 in 2020
Per Capita MA GDP:
337 in 2020
MA Wage and Salary:325 in 2020
MA Consumer Price Index
(CPI):224 in 2020
1991=100
Source: Payment Reform Commission/Mass. Dept. of Health Care Finance and Policy
Key Driver: State Revenues$
Bill
ions
Source: Mass. Taxpayers’ Foundation * EstimateFiscal year
Key Driver: Variation in Pricing
Source: Mass. Office of the Attorney General. Examination of Health Cost Trends and Cost Drivers. March 16, 2010
What We Used
The Commission Reports
On The Road Again
More Content
The Governor’s Pitch …
... and ours
Doctors’ Day
What We Learned …
• Getting the membership engaged on costs- Give them a voice (Focus groups, etc.)- Let them debate- Feed back to them what they say (Communications)- Convincing the members on issues that will/will not work- Repeat early and often
• Develop mechanisms to continuously evolve as outside forces change
• Engage external stakeholders on members’ issues• Coalitions remain important
Contact InformationCharles Alagero, Esq.VP and General Counsel(781) [email protected]
Elaine Kirshenbaum, MPHVP, Health Policy, Planning and Member Services(781) [email protected]
Frank Fortin, CAEChief Digital Strategist and Communications Director(781) [email protected] @frankfortin
Download this presentation at www.slideshare.net/massmed
