Health Care Reform: A National Conference on Health Care Reform in Massachusetts

Posted on February 4, 2010


The Health Connector was a 2009 winner of the Innovations in American Government Award from the Ash Center at Harvard University’s Kennedy School of Government. In addition to the recognition, the state received a monetary award from the Ash Center, to be used specifically to disseminate knowledge gained through innovation to other government entities that might be interested in replication or lessons learned.

After careful consideration, the Connector decided to use a very small part of our grant award to fund participation in an international conference on health reform and the vast bulk of the award to develop a conference at which other states could learn about the Connector’s work and broader themes of state-based health reform. In partnership with AcademyHealth and the Robert Wood Johnson Foundation’s State Coverage Initiatives Program, the state co-hosted this national conference last month, January 21-22, in Boston.  It was titled “How to Organize Exchanges and Other Lessons Learned.”

The conference attracted policymakers from 41 states plus the District of Columbia to learn how key facets of Massachusetts’ health care reform experience were planned and implemented, and to consider the implications of related provisions under discussion in Washington, D.C.

The first afternoon focused on payment and delivery systems reform-an agenda still very much in front of Massachusetts and of broad national interest.  First-day speakers and panelists included David Helms, president and CEO of AcademyHealth, Donald Berwick, M.D., president and CEO of the Institute for Healthcare Improvement, Professor Stuart Altman of Brandeis University, Massachusetts Administration and Finance Secretary Jay Gonzalez, Health and Human Services Secretary JudyAnn Bigby, M.D., and the co-chairs of the Joint Legislative Committee on Health Services Financing (Senator Richard Moore and Representative Harriett Stanley). The second day ran from 8:00 a.m. to 4:45 p.m. and featured sessions for visiting state officials on critical components of our reform effort. These sessions addressed the advantages and challenges of having a state exchange as well as how the Health Connector is structured, how it operates its subsidized and unsubsidized programs, performs outreach and public education activities as well as some lessons learned, mistakes to avoid and how states can prepare for federal reform.

The agenda and presentations for the conference are as follows:


  • Welcome

Jon Kingsdale, Executive Director, Massachusetts Health Insurance Connector Authority

David Helms, President and CEO, AcademyHealth

  • Introductory Remarks

Jay Gonzalez, Massachusetts Secretary of Administration and Finance and Chairman of theMassachusettsHealth Insurance Connector Authority Board

  • The Future of Massachusetts Health Reform:  Reforming the Delivery & Payment Systems to Improve Outcomes & Contain Costs

Don Berwick, President and CEO, Institute for Healthcare Improvement – View Presentation

Stuart Altman, Professor of National Health Policy, Brandeis University – View Presentation

Reactors: JudyAnn Bigby, MD, Massachusetts Secretary of Health and Human Services

Massachusetts State Senator Richard Moore

Massachusetts State Representative Harriett Stanley


  • Session 1: Overview of Massachusetts Health Care Reform: The Advantages and Challenges of Having a State Exchange

This session will provide context for how Massachusetts has reached significant milestones with health reform, reviewing the process of implementation and the overall structure of the Massachusetts Health Connector. This session also will review the benefits of having a state exchange as well as the key issues that a state should consider when determining whether to pursue a state-level exchange. View Presentation

Jon Kingsdale, Executive Director, Massachusetts Health Insurance Connector Authority

  • Session 2: Commonwealth Care

This session will provide an overview of Commonwealth Care, the state’s subsidized health insurance program. Presenters will discuss how the state determines and re-determines eligibility, handles patient appeals, the determination and delivery of subsidies, contracting with managed care organizations and other health plans, bidding strategies, and risk adjustment protocols.

Rosemarie Day, Deputy Director, Connector Authority: Overview  View Presentation

Patrick Holland, CFO, Connector Authority: Procurement, Risk Adjustment, Working with the MCOs  View Presentation

Deb Enos, CEO, Neighborhood Health Plan: Managed Care Organization Perspective  View Presentation

Robin Callahan, Director of Member Policy and Program Development, Massachusetts Office of Medicaid: Coordination between State Agencies  View Presentation

  • Session 3: Commonwealth Choice

This session will focus on Commonwealth Choice, the unsubsidized health insurance program for uninsured adults. Panelists will cover various issues related to the program including:implementing insurance market reforms, negotiating with health plans, awarding the state’s seal of approval, etc.

Kevin Counihan, Chief Marketing Officer, Connector Authority: Overview  View Presentation

Patrick Holland, CFO, Connector Authority: Seal of Approval  View Presentation

Eric Schultz, CEO, Fallon Community Health Plan: Health Plan Perspective  View Presentation

  • Session 4: Outreach and Public Education

Outreach and education is a critical component of the reform. This session will review Massachusetts’ public education campaign and partnership building efforts that drove enrollment to a near universal level.

Joan Fallon, Chief Communication Officer, Connector Authority: The Connector’s Public Education Campaign  View Presentation

Bob Nevins, CIO, Connector Authority: The Website As A Critical Tool  View Presentation

Chip Joffe-Halpern, Board Chairman, Health Care for All, and former Health Connector Board member: Grassroots Outreach  View Presentation

  • Session 5: Lessons Learned – Recommendations and Mistakes to Avoid

Panelists will share lessons learned and recommendations for how to proceed in the planning and implementation of an exchange, with a focus on what mistakes to avoid along the way.

Jon Kingsdale, Executive Director, Connector Authority

Mike Widmer, President, Massachusetts Taxpayers Foundation

Nancy Turnbull, Senior Lecturer in Health Policy, Harvard School of Public Health and Connector Board member

Jon Gruber, Professor of Economics, Massachusetts Institute of Technology and Connector Board member

Jamie Katz, General Counsel, Connector Authority

  • Session 6: How States Can Prepare for Federal Reform

Enrique Martinez-Vidal, Vice President, AcademyHealth (moderator)

Bob Carey, Principal and Founder, RLCarey Consulting

John McDonough, U.S. Senate Health, Education, Labor and Pensions Committee (invited)

Chris Koller, Rhode Island Health Insurance Commissioner

Brian Webb, Manager, Health Policy and Legislation, National Association of Insurance Commissioners

Final Remarks

A panel of experts on Massachusetts reform – Nancy Turnbull (Associate Dean at the Harvard School of Public Health), Jon Gruber, Ph.D. (Professor of Public Finance, MIT), and Michael J. Widmer, Ph.D. (President of the Massachusetts Taxpayers Foundation) – summed up the lessons learned as follows:

1. Massachusetts proves that near-universal coverage can be achieved quickly, if framed well and if states can tap into substantial federal funding

2. Implementation of health reform is a continuous political campaign

3. The success of Massachusetts’ health reform suggests the value of delegation and discretion in implementing complex new initiatives, as well as the importance of experienced and professional management in carrying out the reforms

Posted in: Boston, Health Reform