June 25, 2012 1:24 PM

Massachusetts' health care plan: 6 years later

By
Phil Hirschkorn, Jeff Glor

With more people insured, Dr. Somava Stout, who helps oversee primary care for the Cambridge Health Alliance, has seen a surge of new patients and paid bills.

Stout said: "The days of scrounging around to find medicines for someone who can't afford them or find a fancy way to get somebody to a specialist by begging and pleading -- those days are gone."

She predicts health costs will come down as the newly insured seek more preventive care. Already, more women in Massachusetts are getting pre-natal care, and more people are getting cancer screenings.

"We've seen patients come in and get screened for colorectal cancer, gets lots of people diagnosed with polyps before they became cancer," Stout said.

"You have people who before would get their diabetic care in the emergency room who instead are coming into primary care, taking care of their diabetes, not ending up hospitalized every three or every four months. I mean it's a huge difference."

Today, 90 percent of Massachusetts doctors believe quality of care has improved since the reform, which two-thirds of state residents say they support.

"Initially when we began the reform, we really did want to tackle cost and access. I think the final legislation that came out was clearly geared more to access," said Amy Lischko, a Romney health care adviser now at Tufts University.

"We want people to seek care when they need to seek care, but we also want them seeking care at more efficient settings. Watchful waiting may be okay for some illnesses. So we want to educate them more about when to go to the doctor and when not, when to go to the doctor instead of the emergency room," Lischko said.

Hospitals like Massachusetts General, in Boston, are seeing more patients, but fewer visits to emergency rooms for routine care, and unpaid ER visits are down by one third.

"There is too great a fear of coverage reform and almost vilifying the experience we've had here without really understanding how successful things have been," said Dr. Gary Gottlieb, President and CEO of Partners HealthCare, which owns Mass General and eight other hospitals.

"Right now, I think the people made out the best," Gottlieb said. "First, we have people covered. Second, we've started to see a real reduction in the rate of increase in health care costs in this market relative to the rest of the country."

With 98 percent of adults and almost 100 percent of children covered by health insurance, the state's focus is shifting more toward cost control.

"We are tackling that right now," Governor Patrick said.

For example, he has empowered the state's insurance commissioner to reject excessive insurance premium increases like the double-digit rate hikes of recent years.

Patrick said, "This has been a very private sector-focused solution. It is a workable one, as we have shown here in Massachusetts, and we ought to give it a chance."



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