Massachusetts is Seventh best in State Health Care
MASS. HEALTH
Worcester Telegram & Gazette
Jessica Leving
Boston University Washington News Service
10/07/09
WASHINGTON—Massachusetts placed seventh in a national state-by-state ranking of health care quality by the Commonwealth Fund Commission on a High Performance Health System.
The rankings, made public Thursday, were broken down according to access to health care, prevention and treatment, avoidable hospital use and costs, equity, and healthy lives of citizens.
Nationwide, the study found wide variations in health care quality among the states and reported that insurance coverage and affordability is a growing concern.
Massachusetts was first among all states in access, and made the top 10 in all other areas except avoidable hospital use and costs, where it came in at a startling 33. That number is up three from 2007, when the first Commonwealth Fund report appeared. Massachusetts was ranked eighth overall in the 2007 report, and has improved or stayed near the same in most areas.
“In Massachusetts, you see an intense effort to improve,” said Cathy Schoen, senior vice president of the Commonwealth Fund. “Every time we do this report, there’s a lot of scrutiny on getting the numbers right because Massachusetts would like to be number one in all the indicators, not just one.”
Robert Klugman, chief quality officer at UMass Memorial Medical Center, said some of the hospital usage numbers in the report might be skewed by demographics.
“Some of that data is not really reflective of reality,” he said. “There’s definitely room for improvement, but that particular area is a little bit skewed. We have some world-class academic organizations that tend to attract some of the sickest people not only from the state but from the region. There’s an educational cost factor as well in educating the next generation of new doctors and testing new technologies. That makes it difficult to compare apples and oranges.”
Despite the blemish in avoidable hospital use and costs, Toni McGuire, president and CEO of the Great Brook Valley Health Center in Worcester, said there is a lot to be proud of in Massachusetts.
“The best care comes through coordination with the patient as a partner,” she said. “We have really good primary care doctors, which is maybe why our numbers are so high. Where we fall short is where primary care doctors get paid. That’s it. It’s really managing the patient, keeping them informed and doing it in a way that works with the entire system of care—and that means making sure you can recoup your costs.”
Jean C. Sullivan, director of the Center for Health Law and Economics at UMass Medical School, said she was concerned about the slight drop in rankings on equity measures.
“While still relatively high, at seventh overall, this rank is a drop from the first-in-the- nation ranking in 2007,” she said. “It appears that those who remain uninsured in this state are having increasing difficulty getting preventive care and seeing a doctor. Massachusetts health care leaders know that primary care capacity must be addressed and have taken effective steps in that direction; for example, the significant increase in class size at the University of Massachusetts Medical School.”
Jennifer Kritz, spokesman for the Massachusetts Executive Office of Health and Human Services, noted that she had not yet reviewed the full report but added that the state is taking measures to improve health care quality.
“Massachusetts now leads the nation in insurance coverage, and we have also seen improved access to medical and dental care,” she said. “A state commission recently issued recommendations for reforming how we pay for health care. Instead of our current ‘fee-for-service’ system—which rewards more care but not necessarily the right care — the commission endorsed a ‘global payment’ model that prioritizes coordinated, efficient and effective patient care and will ensure the long-term sustainability of reform.”
Neighboring New England states made a good showing in the report as well, with Vermont ranked first overall, and Maine, New Hampshire, Connecticut, and Rhode Island all in the top 25 percent. Mississippi came in last of all the states.
The goal of the study was to examine how states have done and spur action across the country, Ms. Schoen of the Commonwealth Fund said. “Where you live matters… and it shouldn’t,” she said.
Karen Davis, Commonwealth Fund president, added that this report should act as further evidence in support of national health reform and noted that despite the battles in Congress over different versions of a bill, all versions contain some basic overlap in certain areas.
“The cost of not acting is too high,” she said. “This report definitely underscores the urgent need for action on health reform. The proposals pending in Congress would vastly improve health insurance coverage.”
The Commonwealth Fund is a private foundation that supports independent research on health policy reform and performance.
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