Running head: MASSACHUSETTS’ HEALTHCARE REFORMS 1 MASSACHUSETTS’ HEALTHCARE REFORMS 3 Memo To: Prof. Thomas Smith From: Student- Jane Doe Reference: Health Care Policy Date: March 18, 2018 Subject: Massachusetts’ Healthcare Reform Act Massachusetts’ Healthcare Reform Act Rationale Massachusetts State is among the states that have made a number of attempts aimed at reforming the state's healthcare system to make access to quality healthcare available for its residents. Recently in 2006, Massachusetts passed the Healthcare Reform Act, which was later, signed into law by former Governor Mitt Romney (Van der Wees et al., 2013). The rationale for this healthcare reform was to provide near-universal health insurance coverage for Massachusetts’ residents. Adoption of the Reform The Massachusetts Healthcare Reform Act was passed by the State legislators after years of negotiation between Mitt Romney and the legislators with a compromise reached in 2006 resulting in the enactment of the reform that was effectively signed into law by Romney on 12 April 206. The reform has made several changes to its healthcare system in a move aimed at achieving a near-universal healthcare coverage for the residents of the state. The first change was made to the state's Medicaid program that was broadened by providing a MassHealth waiver, extending health insurance coverage to children in low-income families with up to 300% of the federal poverty level (FPL) (Kaiser Family Foundation, 2012). Massachusetts created what is called Commonwealth Care, which provides the residents of the state with access to subsidized health insurance for eligible individuals with earnings below 300% of FPL. Under this new healthcare reform, individuals with income below 150% of FPL also have the option of selecting a plan without a monthly premium and low-cost sharing. However, eligible individuals with earnings falling between 150-300% PL are subsidized by the state using a sliding scale. The Massachusetts Healthcare Reform Act also saw the state expand its Insurance Partnership Program by providing incentives and subsidies to the employers to give and workers to enroll in the state's employer-sponsored insurance. In this respect, Massachusetts State subsidized insurance costs for the workers in the state who would otherwise be eligible for programs subsidized by the government. However, small businesses are only eligible for up to $1,000 in support per qualified worker who falls below the 300% FPL (Van der Wees et al., 2013). Under the program, the state government pays the portion of qualified workers' premiums that is equal to what the employees would be expected to pay if employees were on a subsidized plan. Additionally, under this new healthcare reform, any employer in the state who fails to provide health insurance to its workers is expected to pay what is called a ‘fair share' assessment to the government of up to $295 per worker ever.

1. Running head: MASSACHUSETTS’ HEALTHCARE REFORMS
1
MASSACHUSETTS’ HEALTHCARE REFORMS 3
Memo
To: Prof. Thomas Smith
From: Student- Jane Doe
Reference: Health Care Policy
Date: March 18, 2018
Subject: Massachusetts’ Healthcare Reform Act
Massachusetts’ Healthcare Reform Act
Rationale
Massachusetts State is among the states that have made a
number of attempts aimed at reforming the state's healthcare
system to make access to quality healthcare available for its
residents. Recently in 2006, Massachusetts passed the
Healthcare Reform Act, which was later, signed into law by
former Governor Mitt Romney (Van der Wees et al., 2013). The
rationale for this healthcare reform was to provide near-
universal health insurance coverage for Massachusetts’
residents.
Adoption of the Reform
The Massachusetts Healthcare Reform Act was passed by the
State legislators after years of negotiation between Mitt
Romney and the legislators with a compromise reached in 2006
resulting in the enactment of the reform that was effectively
signed into law by Romney on 12 April 206. The reform has
made several changes to its healthcare system in a move aimed
at achieving a near-universal healthcare coverage for the
residents of the state. The first change was made to the state's
Medicaid program that was broadened by providing a
MassHealth waiver, extending health insurance coverage to

2. children in low-income families with up to 300% of the federal
poverty level (FPL) (Kaiser Family Foundation, 2012).
Massachusetts created what is called Commonwealth Care,
which provides the residents of the state with access to
subsidized health insurance for eligible individuals with
earnings below 300% of FPL. Under this new healthcare reform,
individuals with income below 150% of FPL also have the
option of selecting a plan without a monthly premium and low-
cost sharing. However, eligible individuals with earnings falling
between 150-300% PL are subsidized by the state using a
sliding scale.
The Massachusetts Healthcare Reform Act also saw the state
expand its Insurance Partnership Program by providing
incentives and subsidies to the employers to give and workers to
enroll in the state's employer-sponsored insurance. In this
respect, Massachusetts State subsidized insurance costs for the
workers in the state who would otherwise be eligible for
programs subsidized by the government. However, small
businesses are only eligible for up to $1,000 in support per
qualified worker who falls below the 300% FPL (Van der Wees
et al., 2013). Under the program, the state government pays the
portion of qualified workers' premiums that is equal to what the
employees would be expected to pay if employees were on a
subsidized plan. Additionally, under this new healthcare reform,
any employer in the state who fails to provide health insurance
to its workers is expected to pay what is called a ‘fair share'
assessment to the government of up to $295 per worker every
year (Kaiser Family Foundation, 2012).
The reform also created what is called the Commonwealth
Health Insurance Connector whose primary aim is to link those
without access to employer-sponsored insurance and companies
with 50 or fewer employees that provide insurance coverage for
its workers. According to this health reform, small businesses
with 50 of fewer employees have the option of buying insurance
coverage on their own or via the Connector (Rapoza, 2012).

3. Funding Structure
Although Romney and the state legislators agreed on most of
the components of the bill, agreeing on how this healthcare
reform would be financed was a major issue as it was clear that
financing the reform would result in an increase in healthcare
cost. However, following a compromise that was reached, the
state legislators agreed that the reform would be financed by
individuals, employers and the government. First, the
Massachusetts Healthcare Reform is funded by the existing
$320 million obtained in hospital assessments and covered
levies (Van der Wees et al., 2013). Second, the Massachusetts
state legislators agreed that the health reform would also be
financed through by federal safety-net payments of $610 million
as well as federal matching payments on the MassHealth
expansion. Additionally, part of the money to be used in
financing the health care reform is to come from rate increases
projected at $299 million. Further, $295 fair assessment for
employers per employee and the Free Rider Surcharge also
generates revenue used to finance the ambitious health care
reform in Massachusetts (Kaiser Family Foundation, 2012).
Impacts
The impacts of this Massachusetts Healthcare Reform Act have
been so profound. The first major achievement of this
healthcare reform is that it has increased access to affordable
coverage to residents of Massachusetts. Because the law
requires all residents of Massachusetts to have a health
insurance or pay a fine, the law had seen more that 99% of the
residents of the state now get health insurance coverage up from
90% before this healthcare reform was introduced. According to
Rapoza (2012), prior to 2006, more than 24% of low-income
residents of Massachusetts had no health insurance. However,
by 2012, only 8% of low-income adults in the state were still
without healthcare coverage. Overall, about 650,000
Massachusetts residents who lacked health insurance are now
covered.
Another significant achievement of the Massachusetts health

4. insurance is that it has increased insurance status of higher
income persons for the self-employed who did not qualify for
MassHealth. According to Urban Institute, the population of
higher income earners who were without health insurance before
2006 has dropped from 5% then to below 1% three years after
the reform (Kaiser Family Foundation, 2012).
The only notable shortcoming of this healthcare reform is the
cost burden associated with its implementation. The health cost
in the state has risen to a historic high following the
introduction of this healthcare reform was introduced. By 2007,
just one year after the reform, Massachusetts healthcare
expenditure accounted for about 15.2% of its GDP, which is
higher than the nation's average of 13.7% as a whole (Kaiser
Family Foundation, 2012).
References
Kaiser Family Foundation. (2012). Massachusetts health care
reform: Six years later. Retrieved from
https://kaiserfamilyfoundation.files.wordpress.com/2013/01/831
1.pdf
Rapoza, K. (2012, Jan. 20). If ObamaCare is so bad, how does
RomneyCare survive? Forbes p. 1
https://www.forbes.com/sites/kenrapoza/2012/01/20/romney-
care-massachusetts-healthcare-reform/#3d6701195b00
Van der Wees, P. J., Zaslavsky, A. M., & Ayanian, J. Z. (2013).
Improvements in health status after Massachusetts health care
reform. The Milbank Quarterly, 91(4), 663–689.
Saint Leo University
HCA303
Term Paper: Professional Development Exercise

5. This term paper applies the Buchbinder & Shanks (2017)
textbook to lead HCA303 students
through a process of self-reflection, personal assessment, and
professional development
planning. The term paper is designed to engage students in
better understanding and
articulating professional interests, strengths, and areas for
further learning and
development in preparation for managing and leading health
care organizations in the
future.
The term paper is structured into nine sections, with word count
guidelines provided in each
section. APA formatting is required. Term paper milestone
deadlines, by module, are as
follows:
• Read and familiarize yourself with the term paper assignment
in Module 1
• Begin researching and organizing non-textbook references for
the term paper in
Module 2

6. • Proposed non-textbook term paper reference list is due to the
Dropbox by no later
than Sunday 11:59 PM EST/EDT of Module 4
• A draft of the first four sections of the term paper is due to the
Dropbox by no later
than Sunday 11:59 PM EST/EDT of Module 5
• The final term paper is due to be submitted no later than
Sunday 11:59 PM
EST/EDT of Module 8. Students who do not submit the
assignment will receive a
zero. This is a key program assessment; the results are used to
ensure students are
meeting program goals. Video and PDF instructions can be
found on the course
home page. PDF instructions are also located in the Start Here
folder.

7. Section 1: Organizational Settings
Below are 25 categories of organizational settings in the health
industry. In about 250
focused and concisely written words, (a) select one according to
your interest for the
organization setting of a future health care management position
and (b) explain why you
choose such an organization.
• Community hospitals
• Pharmaceutical/biotechnology
• Health systems/integrated delivery companies networks
• Medical devices/equipment
• Academic medical centers
• Physician practices
• Federally qualified health centers
• Outpatient diagnostic facilities

8. • Home health care
• Surgery centers
• Hospice care
• Urgent care centers
• Dental offices
• Health information systems
• Government agencies
• Insurance/managed care companies
• Public health
• Continuing care retirement communities
• International health care
• Nursing homes/skilled nursing facilities
• Assisted living facilities
• Consulting
• Higher education
• Professional associations
• Entrepreneurship

9. Section 2: Leadership
Apply the leadership concepts in Chapter 2 (e.g., competencies,
models, styles, protocols,
responsibilities) in answering the following three items in a
total of about 400 words.
Incorporate at least two references above and beyond the
textbook, and cite both the
textbook and your external references using APA style.
(a) Think about a situation where you (or an organizational
leader you are familiar with)
were highly effective as a leader. Apply leadership concepts
from Chapter 2 in explaining
your (or the selected leader’s) effectiveness. You may write
about yourself, a leader in
the health industry, or a leader from outside the health industry.
(b) Think about a situation where you (or an organizational
leader you are familiar with)

10. were ineffective as a leader. Apply leadership concepts from
Chapter 2 in explaining
your (or the selected leader’s) ineffectiveness. You may write
about yourself, a leader in
the health industry, or a leader from outside the health industry.
(c) State and describe three personal leadership development
goals.
Section 3: Motivation
Apply the motivation concepts in Chapter 3 in answering the
following three items in a total
of about 400 words. Incorporate at least two references above
and beyond the textbook,
and cite both the textbook and your external references using
APA style. The external
references cited in this section will very likely be different from
those in the previous
section.
(a) What motivates you?
(b) What demotivates you?

11. (c) As a health care manager, what will be your approach to
increasing employee
engagement and motivation in your organization?
Section 4: Cognition and Organizational Behavior
Apply the concepts in Chapter 4 in answering the following
item in a total of about 150
words. Incorporate at least one reference above and beyond the
textbook, and cite both the
textbook and your external reference(s) using APA style.
Discuss the role of cognition (thinking, reasoning) in promoting
organizational change and
learning. In what ways could you, as a manager, use cognition
to improve communication
and teamwork?
Section 5: Strategic Planning, Marketing, Health Information
Technology, Financial
Management, and Human Resources Management
Strategic planning (Chapter 5), marketing (Chapter 6), health

12. information technology
(Chapter 8), financial management (Chapters 9 and 10), and
human resources
management (Chapter 12) are fundamentally important areas of
management focus in
health care organizations. Answer the following two items in a
total of about 500 words.
Incorporate at least two references above and beyond the
textbook, and cite both the
textbook and your external references using APA style.
(a) Assess your level of knowledge, experience, and interest in
strategic planning,
marketing, health information technology, financial
management, and human resources
management.
(b) Using the top-ranked health industry setting from Section 1
as the organizational
context, present and discuss a set of seven personal professional
development goals you
would like to achieve in the next 3-10 years. These goals
identify desired experiences,
activities, and responsibilities for your professional growth and

13. career development in the
areas of strategic planning, marketing, health information
technology, financial
management, and/or human resources management. For
example, a practicing nurse may
have the career goal of becoming involved in leading
organizational efforts to apply health
information technology to further improve the work done by
nurses and other caregivers.
Section 6: Health Care Professionals
The number of different job categories and titles in the health
industry is very large
(Chapter 11). In about 200 words, (a) identify five health
industry job titles with whom
you’ve never worked in a significant way and (b) propose a
personal professional
development plan to better acquaint yourself with the roles and
responsibilities held by
individuals in these positions. For example, someone currently
working in the billing and
coding area might arrange to spend several days with a home
health nurse in order to

14. experience and learn more about home health care services
delivery. Incorporate at least
one reference above and beyond the textbook, and cite both the
textbook and your external
reference(s) using APA style. To assist in thinking about the
range of job categories and
titles in the health industry, the following U.S. Bureau of Labor
Statistics link provides
information on a sampling of health care occupations:
http://www.bls.gov/ooh/healthcare/home.htm.
http://www.bls.gov/ooh/healthcare/home.htm
http://www.bls.gov/ooh/healthcare/home.htm
http://www.bls.gov/ooh/healthcare/home.htm
http://www.bls.gov/ooh/healthcare/home.htm
Section 7: Quality Improvement and Teamwork Address the
following scenario in about 500 words:
Shortly after graduation, your new boss asks you to organize
and lead a cross-

15. departmental, multi-disciplinary team to improve coordination,
efficiency, and effectiveness
in the care of patients with multiple chronic conditions. Apply
the concepts and tools of
Quality Improvement (Chapter 7) in combination with those of
Teamwork (Chapter 13) and
Motivation (Chapter 3) to outline your approach to organizing
and managing a quality
improvement team. Incorporate at least three references above
and beyond the textbook,
and cite both the textbook and your external references using
APA style.
Section 8: Health Disparities
In about 250 words, apply the Saint Leo University core value
of Community in a
brief proposal for a community health improvement initiative to
address a health disparity
or health inequity in a location of your choosing. Incorporate at
least two references above
and beyond the textbook, and cite both the textbook and your
external references using
APA style.

16. Section 9: Health Ethics
Answer the following two items in a total of about 300 words.
Incorporate at least two
references above and beyond the textbook, and cite both the
textbook and your external
references using APA style.
(a) Assess your level of knowledge and experience with key
health ethics principles such as
respect, autonomy, confidentiality, beneficence,
nonmaleficence, and justice.
(b) Why are ethical behavior and decision making so important
for health care managers?
(c) Describe three personal professional development goals that
will further prepare you in
becoming a health care manager characterized by ethical
behavior and decision making.