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February 2012

Developing health insurance exchanges. Maintaining coverage for people with disabilities. Enhancing primary care. Identifying gaps in health care systems.

At Commonwealth Medicine, the health care consulting and operations division of UMass Medical School, we are doing all this and more, as we apply academic research, an evidence-based approach, and public service expertise to today’s most pressing health care reform issues.

Measuring reform's effect on disabled populations

In Massachusetts
Massachusetts health care reform has reduced the uninsurance rate among working-age people with disabilities by approximately half, according to a recent study our team published in the journal Inquiry. Authors Jack Gettens, Ph.D., Monica Mitra, Ph.D., Alexis Henry, Sc.D., OTR/L, and Jay Himmelstein, M.D., M.P.H., also show that state health care reform reduced the cost-related problems that can prevent this population from obtaining care. However, cost remains an obstacle, particularly for young adults with disabilities.

The study demonstrates that the Behavioral Risk Factor Surveillance System (BRFSS) — a public health survey — may be an important source of data for states seeking estimates on the effects of the federal Affordable Care Act (ACA).

Nationwide
A second health care reform study, published in the Journal of Disability Policy Studies by Gettens, Henry, and Himmelstein, assesses the ACA and estimates that it could enable approximately 2 million people with disabilities to gain health insurance. The assessment also reveals a probable unintended consequence of the ACA — some people with disabilities may either lose Medicaid coverage or experience reductions in coverage.

Surveying views of comparative effectiveness research

Little is known about how medical and pharmacy directors in public and private health plans use comparative effectiveness research to set medical payment policy — or how such research affects their views of related national policy issues.

Our Office of Survey Research is helping to find answers to those questions, in support of a study being conducted by Joel S. Weissman, Ph.D., of Brigham and Women's Hospital and Harvard Medical School. Our team is surveying pharmacy and medical directors in all 50 states' Medicaid programs, as well as 100 of the nation's largest commercial insurance companies.

Identifying health care gaps

We received a $378,000 grant to conduct the Connecticut Health Care Survey. The project, led by Office of Survey Research Director Zi Zhang, Ph.D., is funded by the Aetna Foundation, the Connecticut Health Foundation, the Patrick and Catherine Weldon Donaghue Medical Research Foundation, the Foundation for Community Health, and the Universal Health Care Foundation of Connecticut, Inc.

Our Office of Survey Research is gathering experiences and perspectives from Connecticut residents about their health and the health care system. This data will help identify perceived health care gaps in the state.

Transforming primary care

Our team is providing support and direction for the Rhode Island Chronic Care Sustainability Initiative, which has brought together payers, providers, purchasers, consumers, and other stakeholders to lead the transformation of primary care in the state. This two-year contract, which began in December, builds on our extensive experience with patient-centered medical homes.

In Massachusetts, we are part of the Patient-Centered Medical Home Initiative (PCMHI), a state-sponsored, multipayer demonstration project involving 46 practice sites. While the PCMHI project includes several organizations in addition to UMass Medical School, our team is providing technical assistance that will help primary care practices move to patient-centered medical home models.

Evaluating the ACA's State Basic Health Program option

Our Center for Health Law and Economics team recently analyzed the implications of implementing the ACA’s State Basic Health Program (SBHP) option in Connecticut.

A research brief by authors Katharine London, M.S., and Robert W. Seifert, M.P.A., highlights three main conclusions:

• The SBHP enables states to provide health benefits that are affordable for low-income individuals and cost-neutral for the state.
• Connecticut must decide whether to include an SBHP in its insurance structure — and must align the timing of that decision with its efforts to design a health insurance exchange.
• To plan and implement a health insurance exchange and an SBHP by January 2014, the Connecticut Legislature must act during its 2012 session.

For more information

Contact Patrice MacCune by email or at 508-421-5827 to learn more.

Commonwealth Medicine
University of Massachusetts Medical School
333 South Street • Shrewsbury, MA 01545

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