MMS State of the State: JudyAnn Bigby- Overview of the State of the State's Healthcare

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  • MMS State of the State: JudyAnn Bigby- Overview of the State of the State's Healthcare

    1. 1. Overview of the State of the State’s Healthcare Secretary JudyAnn Bigby Massachusetts Medical Society October 2008
    2. 2. Overview of the State of the State’s Healthcare <ul><li>Access </li></ul><ul><li>Costs </li></ul><ul><li>Financial Performance </li></ul><ul><li>Long term Care </li></ul><ul><li>Physician Workforce </li></ul><ul><li>Quality </li></ul><ul><li>Disparities </li></ul><ul><li>Summary </li></ul>
    3. 3. Insurance
    4. 4. Health Insurance
    5. 5. Health Insurance
    6. 6. Health Insurance
    7. 7. Health Insurance
    8. 8. Access
    9. 9. Access to Providers
    10. 10. Impact on Access to Care Source: On the Road to Universal Coverage: Early Impacts of Health Reform in Massachusetts (Sharon Long, Urban Institute June 2008)
    11. 11. Impact on Access to Care Source: On the Road to Universal Coverage: Early Impacts of Health Reform in Massachusetts (Sharon Long, Urban Institute June 2008)
    12. 12. Impact on Affordability of Care Source: On the Road to Universal Coverage: Early Impacts of Health Reform in Massachusetts (Sharon Long, Urban Institute June 2008)
    13. 13. Impact on Affordability of Care: Out-of-Pocket HC Costs Source: On the Road to Universal Coverage: Early Impacts of Health Reform in Massachusetts (Sharon Long, Urban Institute June 2008)
    14. 14. Problems paying bills and medical debt for low-income adults Source: On the Road to Universal Coverage: Early Impacts of Health Reform in Massachusetts (Sharon Long, Urban Institute June 2008)
    15. 15. Health Care Costs
    16. 16. Health Care Costs
    17. 17. Financial Performance
    18. 18. Financial Performance
    19. 19. Financial Performance
    20. 20. Financial Performance
    21. 21. Financial Performance
    22. 22. Financial Performance
    23. 23. Financial Performance
    24. 24. Financial Performance
    25. 25. Nursing Facility Industry Profile All Payers <ul><li>Number of Facilities: 433 </li></ul><ul><ul><li>Urban Facilities: 113 </li></ul></ul><ul><li>Number of Licensed Beds (1/1/08 Census): 47,946 </li></ul><ul><ul><li>Average Occupancy (1/1/08 Census): 91% </li></ul></ul><ul><li>Licensed beds in Urban Areas (1/1/08 Census): 10,902 </li></ul><ul><ul><li>Average Urban Occupancy (1/1/08 Census): 91% </li></ul></ul><ul><li>Percentage For-Profit: 73% </li></ul><ul><li>Total Industry Revenue 2007 - $3.7B </li></ul><ul><li>Payer Mix </li></ul><ul><ul><li>MassHealth 66.9% </li></ul></ul><ul><ul><li>Medicare 14.5% </li></ul></ul><ul><ul><li>Private/Other 17.4% </li></ul></ul>
    26. 26. MassHealth Nursing Facility Utilization & Spending FY 03-08
    27. 27. MassHealth Long-term Care Spending: FY03 - 08
    28. 28. Physician Workforce <ul><li>MMS Workforce Study 2008 Critical or Severe Shortages </li></ul><ul><ul><li>Dermatology </li></ul></ul><ul><ul><li>Emergency Medicine </li></ul></ul><ul><ul><li>Family Medicine </li></ul></ul><ul><ul><li>General Surgery </li></ul></ul><ul><ul><li>Internal Medicine </li></ul></ul><ul><ul><li>Neurology </li></ul></ul><ul><ul><li>Oncology </li></ul></ul><ul><ul><li>Orthopedics </li></ul></ul><ul><ul><li>Psychiatry </li></ul></ul><ul><ul><li>Urology </li></ul></ul><ul><ul><li>Vascular Surgery </li></ul></ul>* Residents, fellows, semi-retired, retired, temporarily not in practice, not active physicians excluded 2007 State Physician Workforce Data Book, Association of American Medical Colleges
    29. 29. Quality of Care <ul><li>Generally Massachusetts ranks very highly among nationally applied indicators </li></ul><ul><ul><li>Mass ranks as well as or better than national average on 23 of 24 ARHQ indicators </li></ul></ul><ul><li>Opportunity for focus and alignment of: </li></ul><ul><ul><li>Measures </li></ul></ul><ul><ul><li>Focus </li></ul></ul><ul><ul><ul><li>Chronic disease </li></ul></ul></ul><ul><ul><ul><li>Care transitions and coordination </li></ul></ul></ul><ul><ul><li>Attention to clinical care in arenas other than hospitals </li></ul></ul><ul><ul><li>As a means to control costs </li></ul></ul><ul><li>Lots of Activity </li></ul><ul><li>HCQCC </li></ul><ul><li>MAHP and individual health plans </li></ul><ul><li>Mass Health Quality Partners </li></ul><ul><li>Mass E-Health Collaborative </li></ul><ul><li>MassPro </li></ul><ul><li>Mass Coalition for Prevention of Medical Errors </li></ul><ul><li>State Quality Improvement Institute </li></ul><ul><li>Mass Health Data Consortium </li></ul><ul><li>Medicare </li></ul><ul><li>Bridges to Excellence </li></ul><ul><li>National Quality Forum </li></ul><ul><li>IHI </li></ul><ul><li>Leapfrog </li></ul>
    30. 30. Disparities
    31. 31. Disparities From: Long S. Who Gained the Most Under Health Reform in Massachusetts? Massachusetts Health Reform Policy Brief October 2008
    32. 32. Disparities <ul><li>Racial and Ethnic Health Disparities by EOHHS Regions in </li></ul><ul><li>Massachusetts – November 2007 </li></ul><ul><li>Summarizes disparities in health status, risk factors, mortality by region in Massachusetts </li></ul><ul><li>There are wide spread racial and ethnic disparities in all regions of the Commonwealth </li></ul><ul><li>http://www.mass.gov/Eeohhs2/docs/dph/research_epi/disparity_report.pdf </li></ul>
    33. 33. Summary <ul><li>Access to care is improving for many segments of the population </li></ul><ul><ul><li>The number of uninsured is decreasing at a significant rate </li></ul></ul><ul><ul><li>There is a significant decline in uninsured among low-income, among part time workers, among Hispanics </li></ul></ul><ul><ul><li>Financial barriers to access have decreased </li></ul></ul><ul><ul><li>The percentage of Mass residents who report having a regular provider increased for the first time in years </li></ul></ul><ul><li>In 2007 the financial performance of hospitals, health centers, health plans was positive </li></ul><ul><ul><li>Performance in early FY08 looked positive but economic downturn has already had a significant impact </li></ul></ul><ul><li>The balance of LTC for elderly and disabled is shifting to community settings </li></ul><ul><li>Physician workforce shortage is of concern but drivers need to be examined </li></ul><ul><li>Massachusetts has a great opportunity to assess impact of closing gap in disparities in access on disparities in health outcomes </li></ul>
    34. 34. What’s Coming Up? <ul><li>Payment reform </li></ul><ul><ul><li>Expansion of P4P </li></ul></ul><ul><ul><li>Commission on Payment Reform </li></ul></ul><ul><ul><li>Patient Centered Medical Homes demonstrations </li></ul></ul><ul><li>Health Information Technology </li></ul><ul><ul><li>Mandated CPOE and EMR </li></ul></ul><ul><ul><li>E-Health Institute </li></ul></ul><ul><ul><li>Data from E-Health Collaborative </li></ul></ul><ul><li>Transparency </li></ul><ul><ul><li>Quality and Costs on consumer friendly website </li></ul></ul><ul><ul><li>Posting of medical errors and infections </li></ul></ul>

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