Controlling Health Care Spending - The Massachusetts Experiment

Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
New England Journal of Medicine (Impact Factor: 55.87). 04/2012; 366(17):1560-1. DOI: 10.1056/NEJMp1201261
Source: PubMed


As debate rages on about implementation of the Affordable Care Act (ACA), national attention is once again focused on Massachusetts, which instituted a similar comprehensive health care reform package in 2006. After expanding health insurance coverage to almost 98% of the state population, Massachusetts is now struggling to control increasing health care costs that threaten the continued viability of its reforms. This second phase of health care reform presents entirely new challenges. Whereas expanding coverage has popular appeal, cost control does not. Whereas expanding coverage injects additional dollars into the health care system, cost control does the opposite. Whereas expanding . . .

Full-text preview

Available from:
  • Source
    • "" One Hope provides health care services on a $15.00 donation basis for doctor's visits, but does not have the capacity to come anywhere close to meeting the healthcare need in the community. Currently, debate is raging in the U.S. about the sustainability of the healthcare system (Berwick and Hackbarth 2012; Song and Landon 2012). One of the biggest barriers to improving health being discussed on a national level is cost (Harrop 2012; Hensley 2012). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Diabetes is a national health problem, and the burden of the disease and its consequences particularly affect Hispanics. While social determinants of health models have improved our conceptualization of how certain contexts and environments influence an individual's ability to make healthy choices, a structural violence framework transcends traditional uni-dimensional analysis. Thus, a structural violence approach is capable of revealing dynamics of social practices that operate across multiple dimensions of people's lives in ways that may not immediately appear related to health. Working with a Hispanic immigrant community in Albuquerque, New Mexico, we demonstrate how structural forces simultaneously directly inhibit access to appropriate healthcare services and create fear among immigrants, acting to further undermine health and nurture disparity. Although fear is not normally directly associated with diabetes health outcomes, in the community where we conducted this study participant narratives discussed fear and health as interconnected.
    Full-text · Article · Sep 2013
  • [Show abstract] [Hide abstract]
    ABSTRACT: Before 2006, Massachusetts had more than 500 000 residents who lacked health insurance. Governor Mitt Romney enacted landmark legislation requiring all residents to obtain health insurance. Also, the legislation established a health insurance exchange for the purpose of broadening the choices of insurance plans made available to individuals in the state. The purpose of this research was to assess the Massachusetts health care reform in terms of access, cost, and sustainability. The methodology used was a literature review from 2006 to 2013; a total of 43 references were used. Health reform resulted in additional overall state spending of $2.42 billion on Medicaid for Massachusetts. Since the 2006 reform, 401 000 additional residents have obtained insurance. The number of Massachusetts residents who had access to health care increased substantially after the health care reform was enacted, to 98.1% of residents. The Massachusetts health care reform has not saved money for the state; its funding has been covered by Federal spending. However, reform has been sustained over time because of the high percentage of state residents who have supported the state mandate to obtain health care coverage.
    No preview · Article · Oct 2013 · The health care manager
  • Source

    Preview · Article · Jun 2012 · Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital
Show more