Volume 16, No.4, Fall 2008
By Senate President Therese Murray
As leaders in Washington continue to advance national healthcare policy based on our 2006 Healthcare Reform Law, Massachusetts has taken considerable strides to increase access to quality and affordable primary care services.
We recognized that for healthcare reform to be truly successful, affordable health insurance must be paired with healthcare access, especially to primary and preventive care. Increasing the number of primary care professionals in underserved areas, such as Cape Cod, is key to the overall success of our efforts.
The shortage of primary care professionals is a national, and even international, problem. Here in Massachusetts, more than 439,000 individuals who obtained health insurance coverage as a result of the health insurance law in 2006 are now looking for a primary care provider. If we are going to require residents to have insurance, we must make every effort to ensure access to primary care providers. We begin to address this issue in the second phase of healthcare reform.
First, we need to increase the pipeline of doctors choosing to practice primary care in Massachusetts. We have created a new enhanced learning contract program at UMass Medical School which will provide full waivers of tuition and fees to students in exchange for at least four years of service within the Commonwealth in primary care. For medical students at other institutions, we have established a new loan forgiveness program in exchange for a commitment to stay in Massachusetts and practice primary care.
The law also allows patients to choose a nurse practitioner as their primary care provider. By allowing patients to make this choice, we expand access in underserved areas and reduce wait times for appointments. Nurse practitioners also will be deployed throughout the Commonwealth at newly permitted “limited-service clinics.” These facilities may be operated by pharmacies, community health centers or hospitals. By providing another portal for primary care service they will allow quick and easy access to medical consultation for a number of everyday ailments.
When we first sat down more than two years ago to work on the first phase of healthcare reform, we knew state government could not do it alone. It was going to take a collaboration of government, the healthcare industry and private business to ensure success. This second phase is no different. A great example of this partnership is the $10 million fund set up with the help of Bank of America, administered by Partners Healthcare and the League of Community Health centers, to enhance the recruitment and retention of practitioners in individual communities. The first year of this program has placed 35 physicians and 12 nurse practitioners at 23 health centers.
By taking the time to address access, we are going to increase the effectiveness of preventive care and have a healthier Massachusetts.
And There’s More
The new law [EDITOR’S NOTE: which Senator Murray authored] also takes steps to bring down escalating costs by promoting the modernization of the healthcare system to reduce waste and improve quality care. In addition, it creates standards for establishment of independent ambulatory surgical centers—a provision long sought by acute care hospitals—and will force pharmaceutical marketers to disclose payments or perks provided to Massachusetts healthcare professionals.
It will establish the Commonwealth as a national leader in the statewide adoption of electronic medical records and uniform billing, which together could save hundreds of millions of dollars.
This law is crucial for the future vitality of our health care system and our economy. It establishes bold reforms in the structure and operation of our health care industry that will bring down costs and establish transparency measures for providers and insurers alike.
The new law authorizes the Division of Health Care Finance and Policy and the Attorney General to hold an annual public hearing with health care providers and health care insurers to investigate and report on health care cost drivers and make cost-reduction recommendations. It also creates a Special Commission on Health Payment Reform to investigate restructuring the current payment system to provide incentives for efficient and effective care.
Among other major items, the new law also requires:
The law’s requirement for the statewide adoption of electronic medical records also sets a goal of 2015 for implementation and dedicates $25 million for the financing and deployment of the system, which will be overseen by the new Massachusetts e-Health Institute. After 2015, the use of an interoperable health record system would be required for hospital licensure.
The law sets a goal of 2012 for statewide adoption of Computerized Physician Order Entry systems (CPOE). After this date, the use of CPOE systems would be required for hospital licensure. Additionally, the legislation’s standard for uniform billing among health care providers and insurance companies will simplify the current billing structure to reduce administrative costs and errors.
(Senator Murray, D-Plymouth/Upper Cape, is the first female President of the Senate in Massachusetts history.)
By Senator Rob O’Leary
This winter is shaping up to be a tough one, not just here on Cape Cod, but throughout the Commonwealth and the entire nation. Home heating costs are skyrocketing as a result of rapidly rising prices for fossil fuels, which will make it harder than ever for Massachusetts families to stay warm this winter.
A recent survey by the National Energy Assistance Director’s Association (NEADA) showed that 70 percent of low-income households said they reduced spending on food as a result of high energy and gas costs, followed by 31 percent who said they have cut back on purchases of medicine. Staying warm throughout the winter is essential to maintaining health, especially for infants and the elderly.
In response to the predicted escalation in costs, Governor Patrick, Senate President Murray, and House Speaker DiMasi formed the Winter Energy Costs Task Force to explore ways to help citizens cover the cost of home heating. Senator Murray appointed me as the Senate representative to the Task Force and I welcome this assignment.
The Task Force has been charged with examining ways to use existing resources while mobilizing community, volunteer, and philanthropic resources to address service needs.
We have held five public hearings throughout the state where we heard from diverse groups with many different strategies that would be appropriate for the state to adopt. I already have been meeting with many Cape agencies about addressing some of our region’s unique needs.
The legislature is aware of what’s ahead and action has already been taken on Beacon Hill. Before adjourning from formal voting sessions for the fall, I joined my colleagues in voting in support of $10 million in-state supplemental fuel assistance funding, known as the Low Income Heating Energy Assistance Program (LIHEAP). This program helps low income households heat their homes with oil, electricity, natural gas, propane, kerosene, wood and coal.
I also signed onto a letter asking our federal representatives to request additional funding for heating assistance. Governor Patrick joined with New England governors to request $1 billion in federal fuel assistance funding for the region—almost four times what was available last winter. The Department of Public Utilities also has launched a proceeding to improve protections for low-income customers of utilities and called for proposals from utilities for expanding energy efficiency programs this year.
There also are some preventive measures homemakers can take to cope with rising costs:
This is going to be a tough winter and we are doing everything we can in the legislature to provide support for our constituents. But with the economy tightening there likely won’t be enough funds to meet the need. When you learn of a resource, please share this information with friends, relatives and neighbors, especially the elderly.
There are many risks associated with winter heating that go beyond simply being without heat. One in 10 space heater fires results in fatalities. Most heating related fires are due to malfunction of a fuel burner/boiler. Protect yourself by keeping your space heating systems in working order through routine maintenance. Use all space heaters with care.
Furthermore, be sure smoke and carbon monoxide detectors are in working order, as the carbon monoxide released from heating units can be very dangerous. Should you have questions or need help finding services, call my office at 617-722-1570.
(Senator O’Leary, D-Cummaquid, represents the Mid and Lower Cape and Islands and is a member of the Legislature’s Joint Public Health Committee.)
By Representative Cleon H. Turner
In their efforts to contain costs and improve quality of health care for residents, Massachusetts lawmakers face the inescapable need to keep people out of the emergency healthcare system.
With financial turmoil on Wall Street and what seems like a rapidly deteriorating national economy, our ability to afford comprehensive, high-quality medical coverage for all may suffer as employers and individuals find themselves increasingly unable to contribute. In light of this, Massachusetts officials will focus on preventive and chronic care management phase of healthcare reform during the next legislative session.
The first two phases of reform started with a groundbreaking 2006 law that expanded medical coverage and access to insurance to 439,000 residents with employers adding 159,000 previously uninsured individuals to their health plans. The second phase, enacted less than three months ago, focuses on lowering costs through modernization of medical records, reducing influence of pharmaceutical companies on doctors and encouraging more doctors to go into primary care.
As our government and healthcare providers make progress in achieving the goal of an efficient universal coverage, consumers also must contribute to this effort. At a Suffolk University Law School forum September 23, top state healthcare officials stressed that the next phase should focus on increasing personal responsibility and developing individual incentives to pursue healthier lifestyles.
Due to expanded coverage, there is an increased likelihood that previously uninsured individuals will seek medical attention before a disease or a trauma intensifies. However, since 20 percent of people in the healthcare system still use 80 percent of healthcare resources (according to the Boston Globe), we must find more ways to keep people out of the emergency room and guarantee them treatment before illnesses become unmanageable.
We welcome these initiatives and recognize that we must promote healthy lifestyles so people can avoid lengthy and expensive treatment in the first place.
Should extensive state budget cuts become necessary, it is imperative that the Governor and legislative leaders maintain their commitment to effective healthcare for all. Healthcare should not become victim of our current economic travails.
(Representative Turner, D-Dennis, is a member of the Legislature’s Joint Public Health Committee.)