SHOULD MASSACHUSETTS establish mandated nurse-to-patient ratios in law for all the state’s acute care hospitals? This 25-year-old conflict between the Massachusetts Nurses Association and Massachusetts Hospital Association will be determined at the polls on November 6 as Question 1. We think not. We are university professors who care about Massachusetts health care policy. We both […]
John E. McDonough
Posted inHealth Care
Time for Baker to step up on health care
FOR THE BETTER part of this decade, Massachusetts had been on a roll regarding its health system’s performance. Since passage of the 2006 universal health insurance law, we’ve been tops in having the lowest number of uninsured the nation. Recent national surveys on cost, quality, access, and public health from the Commonwealth Fund, the United […]
Posted inOpinion
We need CBO-like scoring of state health care bills
WHEN I WAS A MEMBER of the Massachusetts House of Representatives back in the 1990s, I learned about the concept of continuous quality improvement, or CQI, as a way to improve any process – including medical care – using a rigorous data driven approach. CQI seemed good to me and a natural fit in my […]
Posted inHealth Care
An upstart helps to reshape MassHealth
ON MARCH 1, the state’s Medicaid program—known as MassHealth—entered a new era with the launch of 17 accountable care organizations, or ACOs, aiming to provide better coordinated care at lower costs to its low-income enrollees. It’s an ambitious effort with lots of risk and big potential rewards. Within this is another compelling effort to redefine […]
Posted inOpinion
Silver linings and seeds in tax cut law – Part II
This is the second part of John McDonough’s “Silver Linings Playbook.” Read the first installment here. THE AMERICAN AUTHOR Napoleon Hill wrote: “Every adversity has the seed of an equivalent or greater benefit.” I see this happen in health policy, and specifically, I see it in how the Republican tax cut law signed by President Trump […]
Posted inOpinion
Tax cut’s silver linings playbook
A CORE TENET of behavioral economics is that most of us are biased toward optimism. I plead guilty. Today’s Exhibit A of my optimism bias is the Republican federal tax cut legislation heading toward the desk of President Trump for his signature. It is true that the tax cut legislation is rigged to disproportionately benefit […]
Posted inHealth Care, Opinion, Politics
5 takeaways from Baker’s health reform
PHASE 2 OF THE BAKER ADMINISTRATION’S ambitious health reform agenda emerged this past week. It contains good and smart proposals – and worrisome ones needing attention. Phase 1 is an ambitious effort to transform much of the state’s Medicaid program, known as MassHealth, into “accountable care organizations.” ACOs aim to focus hospitals, physicians, and other […]
Posted inHealth Care, Opinion
A Republican path to ACA reform?
IF PRESIDENT DONALD TRUMP and Congressional Republicans were to decide that fixing rather than destroying the Affordable Care Act, especially its private health insurance marketplaces, was in their self-interest, could they do it? And, could they do it in a way that aligns with Republican policy preferences? The answer to both questions is “yes” – […]
Posted inHealth Care
Bending the Medicaid cost curve
IN A WILDLY uncertain national health care environment, something new, audacious, and risky is happening in MassHealth, the Medicaid program that provides health coverage to 1.9 million people who are poor, elderly, and persons with disabilities in Massachusetts. Gov. Charlie Baker’s administration is betting that an emerging health care delivery and payment model, called “accountable […]
Posted inHealth Care, Opinion
Obamacare more durable than expected
GLOBAL HEALTH EXPERT Michael Reich says that the acid test of any national health reform comes when a new national administration takes over. Only when a new president or prime minister assumes power can we judge the stability and staying power of any health system reform. In the US, that’s this moment. Since November 8, […]