by Larry Pareles, MD
(This is part two of a two-part overview of articles on Massachusetts healthcare issues.)
Despite Massachusetts having some of the best hospitals and healthcare services in the country, these benefits are not equally available to all people, particularly vulnerable populations. Issues include loss of insurance coverage, critical staffing shortages in nursing homes and long-term care, rapidly rising healthcare costs, rising rates of Covid and other respiratory viruses, the continuing challenge of opioid overdose, and access to maternal health services.
Here is a brief overview of how state agencies are addressing some of these problems. As I mentioned in part one, the lack of a single-payer health insurance system in the U.S. means that residents of the Commonwealth will continue to receive fragmented care from a needlessly complex and expensive system that does not meet patient needs.
Many MassHealth members are losing coverage.
About 88,000 people lost MassHealth coverage in October 2023 alone, the largest monthly fall during the year-long process of reassessing 2.4 million members’ eligibility. Most people losing coverage were removed for procedural reasons. A report published by the state Department of Health and Human Services showed that the state’s combined Medicaid and Children’s Health Insurance Program rolls have dropped by a total of 112,000, or 4.7%, since April.
Officials believe the number of disenrollments will nearly triple over the five remaining months in the federally required redetermination campaign. That’s clearly a large number of people losing their healthcare insurance coverage. While some disenrollments occur because members have enrolled in private health insurance through employment, shifted to the Massachusetts Connector for insurance, or moved out of state, advocates will need to monitor the disenrollment process to make sure that Medicaid members and applicants are not being disadvantaged by this federally required reassessment process.
For more details, see this reporting from WBUR.
The Commonwealth faces an inflection point in healthcare costs.
Though Massachusetts prides itself on providing ready access to care and to health insurance coverage, rising health care costs are squeezing individuals and businesses.
“I feel like we are at an inflection point of this health care reform journey,” David Seltz, executive director of the Massachusetts Health Policy Commission, said on The Codcast, “and there needs to be action to update the tools and levers in order for us to maintain our position as a national leader.” Seltz notes that people are having difficulty paying the costs of care not covered by their insurance. Among the fastest-rising costs, outpacing inflation, are those for prescription drugs.
A new respiratory illness tracker is now available.
The state launched a new respiratory illness system to track Covid-19, flu, and RSV (respiratory syncytial virus) in the Commonwealth. Also this story from Boston.com.
Massachusetts funds overdose prevention hotline.
The state is now funding an overdose-prevention hotline that allows people using drugs to be monitored by phone, and receive emergency medical care if they overdose. The Massachusetts Overdose Prevention Helpline is staffed by paid and volunteer workers, many of whom are experienced with drug use. Operating from Boston Medical Center, it provides people preparing to inject, swallow, or snort drugs a 24/7 number to call (800-972-0590) to help them by phone. It is based on a national program Never Use Alone.
When a staffer answers the phone, callers give their addresses and phone numbers. The staffer stays on the phone for at least five minutes after the caller uses drugs. If the caller stops responding, the staffer calls 911. A caller’s address is shared only if there’s a suspected overdose.
“The overdose prevention helpline is an important tool…” said Deirdre Calvert, Director of the Massachusetts Department of Public Health (DPH) Bureau of Substance Addiction Services. “If we want to turn the tide and decrease overdose deaths, we need to support bold innovative programs like the overdose prevention helpline.”
For more info, see these articles.
Two reports urge better access to maternal healthcare.
State officials are pledging to invest in new programs and rewrite regulations to expand access to maternal health care after community hospitals closed or reduced labor and delivery services recently in Beverly, Falmouth and Wareham due to staffing challenges and declining patients. In September another health system made the controversial decision to close its hospital maternity unit in Leominster.
After Gov. Healey ordered health officials to review maternal health care access across the state, two recent DPH reports provided dozens of recommendations.
Dr. Robbie Goldstein, Commissioner of Public Health said: “We are overall a very healthy state… We are a state with a lot of great health care resources. But we are a state that wants to and will hold ourselves accountable to a much higher level… These reports articulate that goal, that we don’t want to just be at the national average. We want to make sure that everyone in Massachusetts has access to high-quality care.”
Leaders of the Massachusetts Nurses Association, who opposed closing the Leominster maternity unit, said the reports are “a positive step” in what should be a concerted effort to improve care for people of color, people from low-income communities — and everyone. For more details, see this article from WBUR.
Dr. Larry Pareles is a retired cardiologist living in Northampton, with more than 35 years’ experience in clinical medicine.