Massachusetts Health Policy Commission
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During this time of difficulty, uncertainty, and reflection, the HPC is immensely grateful for all that you are doing to support the communities you serve. The COVID-19 pandemic has tested our health care systems and has shed new light on longstanding health, social, and economic inequities. In this edition of the
Transforming Care
newsletter, we highlight a new investment program focused on upstream social determinants of health, Moving Massachusetts Upstream, as well as some of the creative approaches that our awardees have taken to meet their patients’ needs in these challenging times.
Let us know if there are care delivery transformation topics or work in the Commonwealth that you would like to see the HPC showcase in this newsletter. We would love to hear from you! Email us at
caredeliverytransformation@mass.gov
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HPC Launches MassUP Investment Program to Target Social Determinants of Health and Promote Health Equity
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“The MassUP investment program represents a unique opportunity to bring the skills and passion of health care providers, community-based organizations, cities and towns, and – most importantly – citizens themselves, to the work of creating lasting improvements to the social, economic, and environmental conditions that influence health and well-being.”
-Marty Cohen, HPC Board of Commissioners Vice-Chair and President and CEO of the MetroWest Health Foundation
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In June 2020, the HPC launched the
Moving Massachusetts Upstream (MassUP)
investment program to address challenges that impact health and well-being that are outside the scope of traditional medical care. The MassUP investment program will support four awardees and their community-based partners in addressing upstream social determinants of health to improve food systems and security and economic stability and mobility. Over the next three years, awardees will work to expand existing community efforts and to strengthen partnerships between providers and community organizations.
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The four MassUP awardees are:
Cooley Dickinson Health Care,
in partnership with
the Collaborative for Educational Services, Hilltown Community Health Center, and Hilltown Community Development Corporation
- Award Funding: $555,555
- Award Design: Form a Hampshire County Food Policy Council to strategically align community organizations to improve regional food security and address systemic barriers to accessing healthy foods.
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Heywood Hospital,
in partnership with
Community Health Network for North Central Massachusetts, GFA Federal Credit Union, Growing Places, The Winchendon School, Three Pyramids, the Town of Winchendon, and Winchendon Community Action Council
- Award Funding: $649,547
- Award Design: Work collaboratively to increase economic stability and mobility in Winchendon through a series of programs that build social, financial, and community assets.
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Massachusetts General Hospital,
in partnership with
The Neighborhood Developers, CONNECT, The Chelsea Collaborative, the City of Revere, the City of Chelsea, and MassHire Metro North Workforce Board
- Award Funding: $649,499
- Award Design: Establish a Cross-City Coalition to coordinate municipal workforce development efforts in the cities of Chelsea and Revere to increase residents’ ability to secure skilled, benefitted jobs.
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Mercy Medical Center,
in partnership with
the Springfield Food Policy Council, Open Pantry Community Services, Fertile Ground, Gardening the Community, and Square One
- Award Funding: $650,000
- Award Design: Create a Springfield MassUP Food Justice Steering Committee to build a more equitable and effective food system and improve access to high-quality, nutritional foods.
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The investment program, a key component of the MassUP initiative, will be administered by HPC in partnership with the Department of Public Health (DPH), which is contributing award funding, providing technical assistance, and conducting an evaluation of the program. The initiative is a partnership across Massachusetts state agencies including the HPC, DPH, MassHealth, the Office of the Attorney General, and the Executive Office of Elder Affairs. The vision of the MassUP initiative is to achieve better health, lower costs, and reduced health inequities in Massachusetts through effective collaboration among government, health care systems, and communities to address social determinants of health. The MassUP initiative includes the MassUP investment program and policy alignment activities. These programs are launching at a critical time when the COVID-19 pandemic has highlighted the devastating impact of existing health inequities among marginalized communities. We look forward to partnering with our awardees in this important and timely work.
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SHIFT-Care Challenge Awardees Adapt to Meet COVID-19 Challenges
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Given the importance of social distancing in preventing the spread of COVID-19, health systems have had to adapt the ways they provide care to their patients. Most providers have replaced in-person visits with telehealth visits, and some have also implemented other creative approaches to meet their patients’ needs. SHIFT-Care Challenge awardees shared some of the ways in which they modified their care models to continue serving their patients who have behavioral health needs and/or health-related social needs.
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- Teleprescribing for opioid use disorder treatment: Nearly all nine of the implementing initiatives to enhance opioid use disorder treatment and their partners have implemented telehealth and teleprescribing services to initiate treatment.
- Expanding availability of telephonic support for patients: Awardees and their partners have made social workers and recovery coaches available telephonically for patient support and outreach.
- Implementing virtual support groups: In addition to expanding telephonic support for patients, the Gandara Center, a peer recovery support center partnering with Holyoke Medical Center, also established virtual support groups for patients to continue connecting with recovery coaches.
- Providing patient transportation: Holyoke Medical Center has reallocated hospital resources to staff vans to provide high-priority patient transportation for patients who have lost access to transportation during the pandemic.
- Conducting virtual home assessments for asthma patients: Springfield Healthy Homes Project at Baystate Health Care Alliance has pivoted from in-person assessments to virtual assessments for asthma-related home repairs.
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SHIFT-Care Challenge awardees and their partners have been nimble and resourceful in meeting patient needs during this public health crisis. We are impressed by their commitment to service and proud to support these organizations as they head towards the finish-line of the SHIFT-Care Challenge program.
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Hebrew SeniorLife Residents and their Families Express their Gratitude to Frontline Workers During the COVID-19 Pandemic
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Hebrew SeniorLife (HSL) has adjusted their SHIFT-Care Challenge processes to expand access to services that address the emerging health-related social needs of all their residents. Many of the residents are unable to accept visitors given the risk of spreading the virus, so the HSL staff has been providing additional support to residents. In addition to providing the usual services, staff is offering emotional and social support and is assisting with basic tasks such as delivering meals, packages, and medication and picking up trash and laundry. Below are some reflections from residents and families:
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“My sister, whom I expected might suffer major depression and anxiety during this period, has felt completely reassured and cared for by the [HSL] staff. Between meal delivery, in-house laundry, Zoomed Sabbath and holiday services - my sister and I have felt so cared for and protected…”
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“My dad has followed the stay in place protocol and has remained healthy and happy throughout this process…
[We appreciate the] cautious optimism and provision of activities for the residents. The phone calls, Zoom calls, and programs, as well as the informative listings, are helpful and encourage the residents to maintain contact with their fellow residents and the staff- those check-ins are wonderful. [My dad’s contact person] has made him smile.”
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The HPC is grateful for all of the ways in which Massachusetts health care providers are continuing to serve their communities during the COVID-19 pandemic, despite the many obstacles and unforeseen challenges they face. If you have received any notes or well-wishes from patients, please email them to us at
caredeliverytransformation@mass.gov
so we can feature them in future editions of the
Transforming Care
newsletter
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PUBLICATIONS, PRESENTATIONS, AND RECOGNITIONS
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HPC Publishes Study on Prescription Drug Coupons
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The HPC’s Prescription Drug Coupon Study analyzes the use and impact of pharmaceutical manufacturer-issued coupons on health care spending and costs, pursuant to Chapter 363 of the Acts of 2018. In conducting this study, the HPC reviewed available literature, received written and in-person testimony from stakeholders, and analyzed data from the Massachusetts All-Payer Claims Database (APCD), other publicly available data, and Massachusetts-specific coupon data procured from Symphony Health.
Key findings:
- 701 branded drugs offered coupons in 2018, compared to 278 branded drugs in 2012.
- Drug coupons were used in 3% of commercial prescription drug claims in 2018.
- The average coupon value per claim was $229 in 2018, with a median value of $55.
- Top three drugs by coupon volume in 2018 were (1) Truvada, an antiviral used for prevention and treatment of HIV; (2) Trulicity, used in the treatment of type 2 diabetes; and (3) Suboxone, used in the treatment of opioid dependence.
- While coupons for some drugs may result in potentially unnecessary higher spending and premiums, many patients do not have alternatives and may depend on coupons to improve drug affordability.
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Boston Medical Center Publishes Paper on SHIFT-Care Initiative
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Congratulations to the SHIFT-Care team at Boston Medical Center (BMC) on their
recent publication
, “A pharmacy liaison-patient navigation intervention to reduce inpatient and emergency department utilization among primary care patients in a Medicaid accountable care organization: A pragmatic trial protocol.” This publication details BMC’s efforts to enhance the role of pharmacy liaisons who also serve as patient navigators and screen for and help address patients’ health-related social needs.
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HPC Releases SHIFT-Care Challenge Awardee Profiles
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The HPC has published
profiles
of the 15 SHIFT-Care Challenge awardees whose programs focus on addressing health-related social needs and promoting access to behavioral health care, including the initiation of medication for addiction treatment for patients with opioid use disorders. The profiles highlight key features of these initiatives, including care models, program aims, target populations, and partnerships with other organizations. The SHIFT-Care Challenge represents approximately $10 million of investment in innovative projects that further the HPC’s goals of better health and better care at a lower cost for all people of the Commonwealth.
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Digital Health Innovation Summit: Global Perspectives on Health and the Pandemic
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The HPC co-sponsored MassChallenge HealthTech’s (MCHT)
Global Innovation Summit
at which providers shared insights on the COVID-19 pandemic and how health systems have used digital health to address new challenges. Kelly Hall, the HPC’s Senior Director of Health Care Innovation and Transformation, moderated a provider panel which included Dr. Mark Zhang of Brigham and Women’s Hospital and Dr. David Klein of Assuta Medical Centers in Israel. The HPC partners with MCHT to promote community-based providers’ access to digital health solutions and to identify digital health tools that may address high-priority policy areas. This year, the HPC served as a Dedicated Advisor to two startups in the 2020 MCHT Cohort:
Health Note
and
EatWell Meal Kits
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HPC Presents Telemedicine Pilot Findings
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UPCOMING EVENTS & RESOURCES
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HPC Board and Committee meetings, and some upcoming meetings and training opportunities offered by non-profit and governmental organizations focusing on health care quality improvement and cost containment.
National Academy for State Health Policy
Webinar
August 17-19, 2020
Massachusetts Health & Hospital Association
Webinar
August 20, 2020
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A sampling of resource materials and publications about COVID-19, telehealth, and health equity, produced by the HPC, other Commonwealth agencies, and non-profit organizations.
Centers for Disease Control and Prevention, 2019
Kaiser Family Foundation, 2020
Institute for Healthcare Improvement, 2016
Health Policy Commission, 2019
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Health Policy Commission
50 Milk Street, 8th Floor
Boston, MA 02109
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