National Lessons from State Health Reform: The Massachusetts Case Study from New Words on Vimeo.
Date and Time: 02/25/2009 2:00pm - 4:00pm (EST)
Where: 2226 Rayburn House Office Building.
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Massachusetts Can Afford Health Care for All: Covering Everyone Comprehensively Without Spending More

One of two studies commissioned by the Massachusetts Medical Society to analyze the impacts and outcomes of single-payer reform in Massachusetts, this report was written by Solutions for Progress and the Access and Affordability Monitoring Project at the Boston University School of Public Health.

The study’s conservative estimates, which would have paid for universal, equal access to health care in Massachusetts through a single state fund, found that the enormous savings from single-payer reform could easily pay for truly universal care for every resident of Massachusetts: insuring the uninsured, covering all services for the underinsured, and completely eliminating cost-sharing such as deductibles, copayments, and coinsurance.

The Solutions for Progress/BU Report can be downloaded below, or from the web-site of BU’s Access and Affordability Monitoring Project.

REPORT DOCUMENTS

• Download all documents from the Access and Affordability Monitoring Project at Boston University’s School of Public Health.
• Press Release
• Summary of Report
• Full Report with Summary and Appendices I and II
• Appendix IIIA - Summary Spreadsheets
• Appendix IIIB - Calculations and Notes
  

OTHER REPORTS ON MASSACHUSETTS SINGLE-PAYER REFORM

• Lewin Group’s Report on single-payer reform: the second study commissioned by the Massachusetts Medical Society.
• LECG’s Report on consolidated and streamlined financing of health care in Massachusetts, commissioned by the Commonwealth of Massachusetts.

REPORT SUMMARY

Massachusetts can provide health care for all its people—and save money.

In the approach to universal coverage examined here:

• Coverage would be comprehensive and secure.
• Patients and payors get a better deal, more care for less money.
• Most of the added care provided would aid people who are now partly insured.
• Cutting administrative waste frees 10 percent of health dollars to pay for more care.
• Reforms in financing and delivery of care would win other substantial savings.
• Over 80 percent of patients’ out-of-pocket costs would be eliminated.
• Caregivers and patients make decisions without bureaucratic interference.
• Trustworthy payment methods enhance quality of care.
• Caregivers gain secure budgets; employers avoid continued premium increases.
• Replacing most out-of-pocket costs with public funds permits administrative savings.

In brief, we conclude that, largely because reforms would have permitted cutting 1999 administrative spending in Massachusetts health care by nearly half, or $3.6 billion, an additional $2.4 billion could have been used for actual care, while still saving $1 billion.

The apparent alternatives are not feasible:

• Adding the same benefits incrementally would cost over $5 billion more.
• Incremental strategies simply increase spending and fail to find administrative, clinical, and other savings.
• Waiting for federal action is dangerous and unnecessary. Massachusetts can afford coverage for all. The time to start planning is now.

The Feasibility of Consolidated Health Care Financing and Streamlined Health Care Delivery in Massachusetts

As part of a Managed Care law passed by the Massachusetts Legislature in 2000 (Chapter 141 of the Acts of 2000, Section 32), the Commonwealth was charged with funding a study to explore the possibilities of “consolidated” financing of health care, combined with “streamlined” delivery.

The report finished in 2002 by LECG, along with providing one of the most detailed portraits of the existing health care system in Massachusetts, estimated three different approaches to consolidating and streamlining our health care. The first was to expand the Medicaid program; the second was to mandate a basic benefit package across all insurers; the third was a single payer system for Massachusetts.

The study found that, by far, a single payer system would provide the most expansive coverage - guaranteeing first rate health care for all residents.

REPORT DOCUMENTS

• Full Report of the LECG.

OTHER REPORTS ON MASSACHUSETTS SINGLE-PAYER REFORM

• Solutions for Progress/Boston University Report on single-payer reform: one of two studies commissioned by the Massachusetts Medical Society.
• Lewin Group’s Report on single-payer reform: the second study commissioned by the Massachusetts Medical Society.

Massachusetts Comparative Projected Health Expenditure Model

One of two studies commissioned by the Massachusetts Medical Society to analyze the impacts and outcomes of single-payer reform in Massachusetts, this report was written by The Lewin Group.

The Lewin Group’s study is a rich source of data for health care costs in the state if we continue to fund business as usual in our health system, and the great promise of single payer reform.

REPORT DOCUMENTS

• Full Report of the Lewin Group.

OTHER REPORTS ON MASSACHUSETTS SINGLE-PAYER REFORM

• Solutions for Progress/Boston University Report on single-payer reform: the second study commissioned by the Massachusetts Medical Society.
• LECG’s Report on consolidated and streamlined financing of health care in Massachusetts, commissioned by the Commonwealth of Massachusetts.

REPORT INTRODUCTION

The Lewin Group has developed a model of health spending in the Commonwealth of Massachusetts. This model was designed to estimate the potential impacts of a single-payer insurance coverage program on health expenditures in that state over the 1998 through 2005 period compared to the projected impacts of the current system during the same time period. The model presents estimates of total program costs, net changes in total state health spending, changes in spending by type of service, and changes in administrative costs.

The model includes Lewin Group “best” assumptions on the impact of a single payer program on health spending in Massachusetts. The model provides outputs that show the impact of the single-payer program on health care expenditures by type of service and type of spending.

Massachusetts Thorpe Report:
ACTION COSTS LESS

This 2005 report by Kenneth Thorpe examines the costs of inaction in Massachusetts, and the potential for health care reforms that implement cost control legislation.

It was commissioned by the Health Care for Massachusetts Campaign (http://www.healthcareformass.org/).

Of particular interest, the Thorpe report estimates the savings from implementing a single-payer system in Massachusetts, as well as a range of cost control initiatives, including:

• Physicians filing electronic claims for state programs.
• Implementing hospital patient safety reporting systems.
• Requiring chronic care management in all state health programs.
• Reducing growth in childhood and adult obesity.

Click here to download the report as a PDF file.
Click here to download the report as a Powerpoint Presentation.