Massachsetts

’s Health Care Essay, Research Paper

Analysis of Massachusetts? Health Care System

Merna Chung

Massachusetts is located in the northeastern section of the United States with a land area of 7 ,838 sq. miles. It is nicknamed the Bay State. The total population of Massachusetts is

6,016,425. Massachusetts has a white majority with the protection of the rights of minorities. There is no single body responsible for making and enforcing health care policy. The majority of the population is White 5,405,374 ( 89.8 % ) ; Blacks 300,130 ( 5.0 % ) ; Hispanic 287,549

( 4.8 % ) ; Asian 143,392 ( 2.4 % ) ; and the American Indian 12,241 ( 0.2 % ). The median age is 33.4 years. 22.5 % is under 18 and 13.6 % is over 65 years.

The major industries are Health Care , tourism, education , farming , and fishing making this state more rural than urban. It is not economically depressed because tourism has become an important factor in the economy.

Health care is a major industry in Massachusetts. It has seen a rapid growth in managed care organizations in recent years. These organizations strive to deliver high quality health care in a cost ? effective manner by using our health care premiums to contract with doctors and hospitals. Two ? thirds to three quarters of Massachusetts residents receive their health care through managed care organizations.

There are many health care systems and managed care organizations in Massachusetts. To name a few – Caregroup Health Care System ; Northeast Health Systems ; Partners Health Care Systems , Inc. Aetna Health Care ; Cigna Health Care of Massachusetts ; ConnectiCare of Massachusetts ; Fallon Community Health Plan ; Harvard Pilgrim Health Care , Inc. ; Health New England , Inc.

In general the population of Massachusetts is very healthy considering that there are so many health care organizations. Massachusetts General Hospital was founded in 1811 and is the third oldest general hospital in the United States and the oldest and largest in New England. This medical center has 820 beds and offers highly sophisticated diagnostic and therapeutic care in every specialty and subspecialty of medicine and surgery. Massachusetts General Hospital

Admits approximately 35,000 in patients each year and handles more than 1 million visits in its outpatient programs at the main campus and at its four health centers. Annually the emergency department at the main campus handle about 80,000 visits. Each year the surgical staff performs nearly 30,000 operations and MGH Vincent Obstetrics Services delivers more than 2,100 births a year. Its 3,700 member medical staff includes physicians , dentists , psychologists , podiatrists , residents and fellows,

In March 1994 , the MGH joined with Brigham and Women ?s Hospital to form Partners Health Care System , Inc. , an affiliation established to create an integrated health care delivery system providing excellent , cost effective care while maintaining the hospital?s dedication to historic teaching and research. Partners? physician network called Partners Community Health Care , Inc. currently includes more than 900 primary care physicians , as well as community hospitals, home health agencies, McLean Hospital, a psychiatrist facility in Belmont, Mass. and Spaulding Rehabilitation Hospital in Boston.

My overall impression of Massachusetts? health care system is very good. Some of the features that stand out are the amount of different high quality health care plans that are available. For example, Harvard Pilgrim Health Care offers three choices. The HMO , the POS and the PPO. They offer First Seniority, a health care plan for Medicare beneficiaries. Harvard Pilgrim Health Care has an extensive network of over 24,000 affiliated providers , thousands of independent physician and group practices and 140 hospitals. They operate in a diverse and increasingly

multi – cultural community therefore, they meet the needs of all their members with appropriate services. Their mission is ? to improve the health of its members and to improve the health of society ?.

Stately Knowledge. 1997

II.Extent of Services

A.Access – language barrier

B.Availability

1. extended hours

2. well staffed

3.primary care physician

III.Affordability

A. Payers – 35 % FFS , 35 % capitation , 30 % salary

B. Medicaid and Medicare programs

C.Cost Control Mechanism

1.Medicaid Managed Program

2.First Seniority

IV.Accountability

A.Regulation

1.State Department of Health

2.Managed Care Ombudsman

3.National Commission on Quality Assurance

B.Planning / Priorities

1.. Healthy People 2000

3.Massachusetts State Planning Council

C.Balance of Powers – Massachusetts has consumer groups involved in monitoring health care

Systems

D.Allegiances / Alliances

1.Pharmaceutical companies provide generic brands to lower cost of prescription drugs

V.Patient Autonomy

A.Patients Bill of Rights

B.Patient Satisfaction – Questionnaires

C.Equity – tries to provide health care to all individuals who are insured , underinsured , or uninsured

VI.Political Rhetoric

A. Government Agencies who provide Medicaid regulates who gets services in low – income families and people over 65

B.Medical schools influence the health care system

VII.Effectiveness of Health Systems

A.Population is healthier because health care is more accessible and treatment is available

B.Critical Health Care Issues that are being addressed

1.Cancer rates decline due to reduced smoking

2.Liver transplant waiting time drops

3.Brain Protein functions identified

4.New U. S. Report removes Saccharin as a cancer cause

C.Steps needed to be taken to improve the health of our population

1.Exercise / Fitness Clubs

2.Diet / Nutrition

3.Stress Management

4.Find a vaccine for the AIDS / HIV population

5.Provide adequate housing for the homeless

? Massachusetts ? Columbia Encyclopedia . Columbia University Press. 1994