Insured the Uninsured Project Conference February 17, 2015 The Future of Reform Thomas P. Traylor Vice President Boston Medical Center/Boston HealthNet.

Insured the Uninsured Project ConferenceFebruary 17, 2015

The Future of Reform

Thomas P. TraylorVice President Boston Medical Center/Boston HealthNet

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“Be patient. Reform takes time”

Reform Takes Time….in Massachusetts

• Massachusetts health reform = 20 year process– 1997 Medicaid Waiver; 14% uninsured– 2006 Medicaid Waiver; vehicle to expand coverage– 2010 Medicaid waiver; launch of Delivery System Transformation

Initiative (DSTI), which is similar to DSRIP– 2014 Medicaid Waiver; 2% uninsured. Uncompensated care pool

and DSTI only funded for 3 years of five-year waiver.

• Reform is still playing out in safety net:– 10% uninsured at BMC today– Medicaid underpayments

• Key policy questions among state and feds– DSTI evolution and continuation post 2017– Open question about funding uncompensated care beyond 2017

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"Your market must evolve. Hospitals & health centers can work together to improve patient care.”

Boston Medical Center’s Evolution5

1995

1996

1997

2012

2014

2015

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“Make a plan. Consider where California wants to be in five years and detail clear cost, quality, and coverage goals. Map out the role of Medicaid.”

What’s the Plan?

1.Detail clear cost, quality and coverage goals.

2.Hold stakeholders accountable for results.

3.Invest in data collection and analysis.

4.Consider relationship among coverage programs.

5.Create a sustainable Medicaid financing plan.

6.Set a realistic timeframe.

7.Convert your complex plan into an understandable story.

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Additional Resources

• Massachusetts Center for Health Information & Analysis– http://chiamass.gov/– Information on cost, quality, access and health system

performance

• The Blue Cross Blue Shield Foundation of Massachusetts – http://bluecrossfoundation.org– Summaries and analysis of MA health reform

• Massachusetts Health Policy Commission– http://www.mass.gov/anf/budget-taxes-and-procurement/oversight-

agencies/health-policy-commission/– Cost Trends Reports

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For Additional Information

Contact:

Tom Traylor, Vice President Boston Medical Center(617) [email protected]

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