Running head: MASSACHUSETTS’ HEALTHCARE REFORMS 1

MASSACHUSETTS’ HEALTHCARE REFORMS 3

Memo

To: Prof. Thomas Smith

From: Student- Jane Doe

Reference: Health Care Policy

Date: March 18, 2018

Subject: Massachusetts’ Healthcare Reform Act

Massachusetts’ Healthcare Reform Act

Rationale

Massachusetts State is among the states that have made a number of attempts aimed at reforming the state's healthcare system to make access to quality healthcare available for its residents. Recently in 2006, Massachusetts passed the Healthcare Reform Act, which was later, signed into law by former Governor Mitt Romney (Van der Wees et al., 2013). The rationale for this healthcare reform was to provide near-universal health insurance coverage for Massachusetts’ residents.

Adoption of the Reform

The Massachusetts Healthcare Reform Act was passed by the State legislators after years of negotiation between Mitt Romney and the legislators with a compromise reached in 2006 resulting in the enactment of the reform that was effectively signed into law by Romney on 12 April 206. The reform has made several changes to its healthcare system in a move aimed at achieving a near-universal healthcare coverage for the residents of the state. The first change was made to the state's Medicaid program that was broadened by providing a MassHealth waiver, extending health insurance coverage to children in low-income families with up to 300% of the federal poverty level (FPL) (Kaiser Family Foundation, 2012). Massachusetts created what is called Commonwealth Care, which provides the residents of the state with access to subsidized health insurance for eligible individuals with earnings below 300% of FPL. Under this new healthcare reform, individuals with income below 150% of FPL also have the option of selecting a plan without a monthly premium and low-cost sharing. However, eligible individuals with earnings falling between 150-300% PL are subsidized by the state using a sliding scale.

The Massachusetts Healthcare Reform Act also saw the state expand its Insurance Partnership Program by providing incentives and subsidies to the employers to give and workers to enroll in the state's employer-sponsored insurance. In this respect, Massachusetts State subsidized insurance costs for the workers in the state who would otherwise be eligible for programs subsidized by the government. However, small businesses are only eligible for up to $1,000 in support per qualified worker who falls below the 300% FPL (Van der Wees et al., 2013). Under the program, the state government pays the portion of qualified workers' premiums that is equal to what the employees would be expected to pay if employees were on a subsidized plan. Additionally, under this new healthcare reform, any employer in the state who fails to provide health insurance to its workers is expected to pay what is called a ‘fair share' assessment to the government of up to $295 per worker every year (Kaiser Family Foundation, 2012).

The reform also created what is called the Commonwealth Health Insurance Connector whose primary aim is to link those without access to employer-sponsored insurance and companies with 50 or fewer employees that provide insurance coverage for its workers. According to this health reform, small businesses with 50 of fewer employees have the option of buying insurance coverage on their own or via the Connector (Rapoza, 2012).

Funding Structure

Although Romney and the state legislators agreed on most of the components of the bill, agreeing on how this healthcare reform would be financed was a major issue as it was clear that financing the reform would result in an increase in healthcare cost. However, following a compromise that was reached, the state legislators agreed that the reform would be financed by individuals, employers and the government. First, the Massachusetts Healthcare Reform is funded by the existing $320 million obtained in hospital assessments and covered levies (Van der Wees et al., 2013). Second, the Massachusetts state legislators agreed that the health reform would also be financed through by federal safety-net payments of $610 million as well as federal matching payments on the MassHealth expansion. Additionally, part of the money to be used in financing the health care reform is to come from rate increases projected at $299 million. Further, $295 fair assessment for employers per employee and the Free Rider Surcharge also generates revenue used to finance the ambitious health care reform in Massachusetts (Kaiser Family Foundation, 2012).

Impacts

The impacts of this Massachusetts Healthcare Reform Act have been so profound. The first major achievement of this healthcare reform is that it has increased access to affordable coverage to residents of Massachusetts. Because the law requires all residents of Massachusetts to have a health insurance or pay a fine, the law had seen more that 99% of the residents of the state now get health insurance coverage up from 90% before this healthcare reform was introduced. According to Rapoza (2012), prior to 2006, more than 24% of low-income residents of Massachusetts had no health insurance. However, by 2012, only 8% of low-income adults in the state were still without healthcare coverage. Overall, about 650,000 Massachusetts residents who lacked health insurance are now covered.

Another significant achievement of the Massachusetts health insurance is that it has increased insurance status of higher income persons for the self-employed who did not qualify for MassHealth. According to Urban Institute, the population of higher income earners who were without health insurance before 2006 has dropped from 5% then to below 1% three years after the reform (Kaiser Family Foundation, 2012).

The only notable shortcoming of this healthcare reform is the cost burden associated with its implementation. The health cost in the state has risen to a historic high following the introduction of this healthcare reform was introduced. By 2007, just one year after the reform, Massachusetts healthcare expenditure accounted for about 15.2% of its GDP, which is higher than the nation's average of 13.7% as a whole (Kaiser Family Foundation, 2012).

References

Kaiser Family Foundation. (2012). Massachusetts health care reform: Six years later. Retrieved from https://kaiserfamilyfoundation.files.wordpress.com/2013/01/8311.pdf

Rapoza, K. (2012, Jan. 20). If ObamaCare is so bad, how does RomneyCare survive? Forbes p. 1 https://www.forbes.com/sites/kenrapoza/2012/01/20/romney-care-massachusetts-healthcare-reform/#3d6701195b00

Van der Wees, P. J., Zaslavsky, A. M., & Ayanian, J. Z. (2013). Improvements in health status after Massachusetts health care reform. The Milbank Quarterly, 91(4), 663–689.

Saint Leo University

HCA303

Term Paper: Professional Development Exercise

This term paper applies the Buchbinder & Shanks (2017) textbook to lead HCA303 students

through a process of self-reflection, personal assessment, and professional development

planning. The term paper is designed to engage students in better understanding and

articulating professional interests, strengths, and areas for further learning and

development in preparation for managing and leading health care organizations in the

future.

The term paper is structured into nine sections, with word count guidelines provided in each

section. APA formatting is required. Term paper milestone deadlines, by module, are as

follows:

• Read and familiarize yourself with the term paper assignment in Module 1

• Begin researching and organizing non-textbook references for the term paper in

Module 2

• Proposed non-textbook term paper reference list is due to the Dropbox by no later

than Sunday 11:59 PM EST/EDT of Module 4

• A draft of the first four sections of the term paper is due to the Dropbox by no later

than Sunday 11:59 PM EST/EDT of Module 5

• The final term paper is due to be submitted no later than Sunday 11:59 PM

EST/EDT of Module 8. Students who do not submit the assignment will receive a

zero. This is a key program assessment; the results are used to ensure students are

meeting program goals. Video and PDF instructions can be found on the course

home page. PDF instructions are also located in the Start Here folder.

Section 1: Organizational Settings

Below are 25 categories of organizational settings in the health industry. In about 250

focused and concisely written words, (a) select one according to your interest for the

organization setting of a future health care management position and (b) explain why you

choose such an organization.

• Community hospitals

• Pharmaceutical/biotechnology

• Health systems/integrated delivery companies networks

• Medical devices/equipment

• Academic medical centers

• Physician practices

• Federally qualified health centers

• Outpatient diagnostic facilities

• Home health care

• Surgery centers

• Hospice care

• Urgent care centers

• Dental offices

• Health information systems

• Government agencies

• Insurance/managed care companies

• Public health

• Continuing care retirement communities

• International health care

• Nursing homes/skilled nursing facilities

• Assisted living facilities

• Consulting

• Higher education

• Professional associations

• Entrepreneurship

Section 2: Leadership

Apply the leadership concepts in Chapter 2 (e.g., competencies, models, styles, protocols,

responsibilities) in answering the following three items in a total of about 400 words.

Incorporate at least two references above and beyond the textbook, and cite both the

textbook and your external references using APA style.

(a) Think about a situation where you (or an organizational leader you are familiar with)

were highly effective as a leader. Apply leadership concepts from Chapter 2 in explaining

your (or the selected leader’s) effectiveness. You may write about yourself, a leader in

the health industry, or a leader from outside the health industry.

(b) Think about a situation where you (or an organizational leader you are familiar with)

were ineffective as a leader. Apply leadership concepts from Chapter 2 in explaining

your (or the selected leader’s) ineffectiveness. You may write about yourself, a leader in

the health industry, or a leader from outside the health industry.

(c) State and describe three personal leadership development goals.

Section 3: Motivation

Apply the motivation concepts in Chapter 3 in answering the following three items in a total

of about 400 words. Incorporate at least two references above and beyond the textbook,

and cite both the textbook and your external references using APA style. The external

references cited in this section will very likely be different from those in the previous

section.

(a) What motivates you?

(b) What demotivates you?

(c) As a health care manager, what will be your approach to increasing employee

engagement and motivation in your organization?

Section 4: Cognition and Organizational Behavior

Apply the concepts in Chapter 4 in answering the following item in a total of about 150

words. Incorporate at least one reference above and beyond the textbook, and cite both the

textbook and your external reference(s) using APA style.

Discuss the role of cognition (thinking, reasoning) in promoting organizational change and

learning. In what ways could you, as a manager, use cognition to improve communication

and teamwork?

Section 5: Strategic Planning, Marketing, Health Information Technology, Financial

Management, and Human Resources Management

Strategic planning (Chapter 5), marketing (Chapter 6), health information technology

(Chapter 8), financial management (Chapters 9 and 10), and human resources

management (Chapter 12) are fundamentally important areas of management focus in

health care organizations. Answer the following two items in a total of about 500 words.

Incorporate at least two references above and beyond the textbook, and cite both the

textbook and your external references using APA style.

(a) Assess your level of knowledge, experience, and interest in strategic planning,

marketing, health information technology, financial management, and human resources

management.

(b) Using the top-ranked health industry setting from Section 1 as the organizational

context, present and discuss a set of seven personal professional development goals you

would like to achieve in the next 3-10 years. These goals identify desired experiences,

activities, and responsibilities for your professional growth and career development in the

areas of strategic planning, marketing, health information technology, financial

management, and/or human resources management. For example, a practicing nurse may

have the career goal of becoming involved in leading organizational efforts to apply health

information technology to further improve the work done by nurses and other caregivers.

Section 6: Health Care Professionals

The number of different job categories and titles in the health industry is very large

(Chapter 11). In about 200 words, (a) identify five health industry job titles with whom

you’ve never worked in a significant way and (b) propose a personal professional

development plan to better acquaint yourself with the roles and responsibilities held by

individuals in these positions. For example, someone currently working in the billing and

coding area might arrange to spend several days with a home health nurse in order to

experience and learn more about home health care services delivery. Incorporate at least

one reference above and beyond the textbook, and cite both the textbook and your external

reference(s) using APA style. To assist in thinking about the range of job categories and

titles in the health industry, the following U.S. Bureau of Labor Statistics link provides

information on a sampling of health care occupations:

http://www.bls.gov/ooh/healthcare/home.htm.

Section 7: Quality Improvement and Teamwork Address the

following scenario in about 500 words:

Shortly after graduation, your new boss asks you to organize and lead a cross-

departmental, multi-disciplinary team to improve coordination, efficiency, and effectiveness

in the care of patients with multiple chronic conditions. Apply the concepts and tools of

Quality Improvement (Chapter 7) in combination with those of Teamwork (Chapter 13) and

Motivation (Chapter 3) to outline your approach to organizing and managing a quality

improvement team. Incorporate at least three references above and beyond the textbook,

and cite both the textbook and your external references using APA style.

Section 8: Health Disparities

In about 250 words, apply the Saint Leo University core value of Community in a

brief proposal for a community health improvement initiative to address a health disparity

or health inequity in a location of your choosing. Incorporate at least two references above

and beyond the textbook, and cite both the textbook and your external references using

APA style.

Section 9: Health Ethics

Answer the following two items in a total of about 300 words. Incorporate at least two

references above and beyond the textbook, and cite both the textbook and your external

references using APA style.

(a) Assess your level of knowledge and experience with key health ethics principles such as

respect, autonomy, confidentiality, beneficence, nonmaleficence, and justice.

(b) Why are ethical behavior and decision making so important for health care managers?

(c) Describe three personal professional development goals that will further prepare you in

becoming a health care manager characterized by ethical behavior and decision making.

Get help from top-rated tutors in any subject.

Efficiently complete your homework and academic assignments by getting help from the experts at homeworkarchive.com