Study: Massachusetts Sustains Coverage and Access Gains from 2006 Reforms

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<p>After implementing an ambitious set of health insurance reforms beginning in 2006, Massachusetts had by 2008 achieved historically high levels of coverage and broad improvements in access to care, according to a <a href="/publications/journal-article/2009/may/access-and-affordability-update-health-reform-massachusetts">new study</a> published online today in <i>Health Affairs</i>. </p>
<p>The researchers, led by Sharon K. Long, Ph.D., of the Urban Institute, found, however, that constraints on provider capacity and rising health costs—trends that predate reform—have eroded some of the gains. Massachusetts is now seeking ways to contain costs and expand provider capacity, including a proposal to shift from fee-for-service provider payments to global fees that emphasize care coordination and collaboration.</p>
<p>The study is the latest in a series of updates on implementation of the Massachusetts reforms funded by the Blue Cross Blue Shield of Massachusetts Foundation, the Commonwealth Fund, and the Robert Wood Johnson Foundation. It reflects the results of interviews conducted in fall 2008 with a representative sample of Massachusetts adults, as well as earlier rounds of interviews from fall 2006 and fall 2007.</p>
<p>"The Massachusetts experience shows that major coverage expansions can be undertaken without addressing costs and provider constraints, but these factors, if they are not addressed eventually, can undercut the benefits from gaining insurance coverage by reducing access to care and the affordability of care," said Long.</p>
<h4>Primer on the Massachusetts 'Connector'</h4>
<p>The Commonwealth Fund also published today an <a href="/publications/issue-briefs/2009/may/massachusetts-commonwealth-health-insurance-connector-structure">issue brief</a> on the Commonwealth Health Insurance Connector Authority—the linchpin of Massachusetts' health reform legislation. The Connector, an independent quasi-governmental agency, was created to facilitate the purchase of affordable, high-quality health insurance by small businesses and individuals lacking access to employer-sponsored coverage. State policymakers intended the Connector to promote administrative ease, eliminate paperwork, offer portability of coverage, and provide some standardization and choice of plans.</p>
<p>The brief, written by Amy M. Lischko, Sc.D., M.P.H., of the Tufts University School of Medicine along with colleagues at Tufts and the Boston University School of Social Work, describes the Connector’s structure and functions, providing a primer to policymakers around the nation interested in this successful model.</p>