Tag Archives: Massachusetts

The Marketplace Premiums Increase: Underwriting Cycle Or Death Spiral?

In this post, we aim to illuminate the underlying forces that led to dramatic increases in premiums so as to clarify the historical record and provide lessons for policymakers who aim to replace the ACA.

February 8, 2017

Weaving Whole-Person Health Throughout An Accountable Care Framework: The Social ACO

As currently structured, most ACOs contain a serious flaw: the vast majority of ACO financing structures, including most of those promoted by CMS and state Medicaid programs, carve out the largest drivers of health: social, environmental, and community factors.

January 25, 2017

Providing A Safe Space And Medical Monitoring To Prevent Overdose Deaths

Opioid overdoses have become the leading cause of death among patients at the Boston Health Care for the Homeless Program. In April 2016, the BHCHP opened an observation and treatment facility to reduce the harms associated with ongoing drug use and provide a safe alternative to the street for...

August 31, 2016

Common Law And Common Sense: The Supreme Court Redresses Patient Harm Under the False Claims Act

In Universal Health Services Co. v. United States ex rel. Escobar, the Supreme Court ruled unanimously that failing to disclose non-compliance with a statutory, regulatory, or contractual requirement could render a claim false or fraudulent.

June 22, 2016

Addressing Price Variation In Massachusetts

Massachusetts has been a national leader in ensuring access to high quality coverage and health care. While the state has made progress on a number of fronts, one substantial ongoing challenge is the significant variation in provider prices for the same sets of services.

May 12, 2016

The Consequences Of Gobeille v. Liberty Mutual For Health Care Cost Control

The Supreme Court’s Gobeille decision invalidated state all-payer claims database reporting requirements for self-funded employee health plans. What are the implications for state and federal health care cost control efforts and how may states access data from self-insured plans moving forward?

March 10, 2016

New Health Care Symposium: Building An ACO—What Services Do You Need And How Are Physicians Impacted?

The strongest case for the ACO model may be that it allows organizations to capture efficiencies if they can achieve them and thus succeed financially with lower revenue growth. It is not certain that organizations can make this transformative turnaround, but the alternative looks particularly bad.

March 3, 2016

New Section 1332 Guidance A Mixed Bag For States

In December, HHS and Treasury released new guidance on how the agencies will evaluate state applications for the ACA’s Section 1332 State Innovation Waivers. For states, it turned out to be a classic example of “be careful what you wish for,” as the the new guidance considerably limits their...

February 29, 2016

Expanding Coercive Treatment Is The Wrong Solution For The Opioid Crisis (updated)

Policymakers face understandable pressure in addressing a surging crisis of opioid abuse. Expanding the scope of involuntary treatment and reducing judicial oversight, however, is an ill-considered response to this public health crisis.

February 11, 2016

The Importance Of Promoting Tobacco Cessation Services For Medicaid Beneficiaries

In an ideal world, promoting prevention would follow logical and easy steps, but the real world of prevention is never this easy. Efforts to broadly implement tobacco cessation services for Medicaid populations, as documented in a January Health Affairs article, demonstrate how difficult it all...

February 11, 2016