The Massachusetts Hospital Association
Payment Reform Report Series

Last July, the Massachusetts Special Commission on the Healthcare Payment System issued broad and wide-ranging recommendations on how to improve the way healthcare is provided and paid for in the Commonwealth. The Massachusetts Hospital Association (MHA) is taking a leading role in the state's healthcare payment reform efforts with a six-part report series outlining a number of issues that must be addressed before plunging in to implementing payment reform. 

On Friday, October 9, the association released  "Massachusetts Payment Reform: An Overview of Critical Foundational Issues" and an executive summary providing an overview of the main issues the in-depth MHA reports will cover: ACOs, the transfer of risk to providers, benefit design, oversight requirements, and how a new payment system will affect societal needs, such as medical education, uncompensated care and behavioral health.

On Friday, November 20, 2009 MHA released "Creating Accountable Care Organizations in Massachusetts: Key Issues for the Commonwealth to Address" and an executive summary which outlines goals and recommends strategies the state can adopt to facilitate successful formation and operation of ACOs.

MHA’s strategic recommendations for ACOs include:

1. Providing adequate and appropriate payment for services
2. Aligning payment methods across payers
3. Ensuring appropriate and efficient quality measurement
4. Facilitating the formation of successful Accountable Care Organizations
5. Addressing key transition issues

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On Thursday, February 4, 2010, MHA released the third part of its six-part series on Massachusetts payment Reform. The latest paper – "Support for Societal Needs: A Critical Issue to Address in Payment Reform" -- examines five societal needs that hospitals and health systems fulfill and the importance of these efforts to the community and economy, and the potential impact of a global payment system on hospitals' ability to continue to meet the needs. The paper also contains appendices that delve in depth into hospital financial issues relating to the Safety Net, Bad Debt and more, as well as a thorough discussion of Graduate Medical Education

MHA identified the following five societal needs:

1. A safety-net for low income patients: An adequate supplemental payment mechanism for providers will be needed to address unpaid care for low-income uninsured and underinsured patients, as well as bad debt.
2. Essential hospital operations in each community around the clock: The provision of healthcare services must be guaranteed for every community 24-hours a day, seven days a week, 365 days a year including disaster readiness and response.
3. Medical education capacity for physicians, nurses and allied medical professionals: Our supply of nurses and physi¬cians is aging and replacement is critical to maintain healthcare access and quality. Professional medical personnel shortages are a fact our nation and Commonwealth must face, and Massachusetts hospitals play a significant role in training those personnel.
4. A robust research capacity for the continued development of improved treatments for disease and injury: Massachusetts teaching hospitals form the nucleus of a vital and thriving medical research complex that has spawned many advances in medical care and both directly and indirectly supports the Commonwealth’s biotechnology industry. Care must be taken that health care payment reform does not kill this “golden goose.”
5. Caring for patients with significant behavioral health and chronic rehabilitative needs: Special attention needs to be given to patients who receive services in a specialized unit of a general hospital or in a specialty hospital.