Massachusetts

ORIGIN AND MISSION
The Massachusetts Health Care Quality and Cost Council is mandated under Massachusetts General Law Chapter 6A and was established by Chapter 58 of the Acts of 2006. The council’s mission is to develop and coordinate the implementation of health care quality improvement goals that are intended to both lower or contain the growth in health care costs and improve the quality of care, including reductions in racial and ethnic health disparities. The council’s vision is that by June 30, 2012, Massachusetts will consistently rank in national measures as the state achieving the highest levels of performance in care that is safe, effective, patient-centered, timely, efficient, equitable, integrated, and affordable.
The council is mandated:

•    To establish statewide goals for improving health care quality, containing health care costs, and reducing racial and ethnic disparities in health care;
•    To demonstrate progress toward achieving those goals; and
•    To disseminate, through a consumer-friendly website and other media, comparative health care cost, quality, and related information for consumers, health care providers, health plans, employers, policy makers, and the general public.

The council is within, but not subject to control of, the Massachusetts Executive Office of Health and Human Services. It reports annually to the legislature on its progress in achieving the goals of improving quality and containing or reducing health care costs, and promulgates additional rules and regulations to promote its quality improvement and cost containment goals.

GOVERNANCE
The council is made up of 16 members that include a diverse group of individuals with a broad array of expertise in the public and private sectors. Subcommittees currently include Chronic Care, Communications and Transparency, Cost Containment, Governance, Patient Safety, and End of Life. The council receives input and advice from a 30-member advisory committee that includes representation from consumers, business, labor, health care providers, and health plans. Through its membership, outreach, and subcommittees, it interfaces across health care in the state.  The council’s budget was reduced from $1.8 million to $1.1 million in 2009 as a result of state budget cuts.

ACTIVITIES AND ACCOMPLISHMENTS
The council is mobilizing stakeholders to address priority areas and is highly inclusive in all considerations. The council anchors its work in measurement, specifically reporting from the Commonwealth of Massachusetts, the Commonwealth Fund State Scorecard, Dartmouth Atlas, RAND, National Quality Forum, and other validated work. Specific accomplishments to date include:

•    Release of its first annual report in April 2008, which identifies specific strategies designed to improve health care quality while containing costs;
•    Establishment of an all-payer claims database via regulations in 2007 and 2008 (see 129 CMR 2.00: Uniform Reporting System for Health Care Claims Data Sets and 129 CMR 3:00: Disclosure of Health Care Claims Data);
•    Launch of a consumer website (MyHealthCareOptions) based on extensive market research. Site includes hospital-level cost (for 20 inpatient and 20 outpatient procedures) and quality information built on an agreed upon set of principles for the selection of measures;
•    Public reporting of serious reportable events by hospital; and
•    Early selection as a state to participate in a four-year, multi-state initiative funded by the Commonwealth Fund and led by the Institute for Healthcare Improvement to reduce avoidable hospitalizations across the state.

NEXT STEPS

The council is working to:

•    Develop a roadmap (by September 2009) to achieve cost containment goals that health care will increase only by inflation rates by July 1, 2012 and that Massachusetts will rank first on The Commonwealth Fund Commission on a High Performance Health System Scorecard;
•    Drive the institution of specific activities, including a statewide campaign by spring of 2009 to improve care at the end of life so that it is respectful of patients’ wishes and includes effective resource utilization;
•    Expand its focus on patient safety to non-hospital environments;
•    Publicly report hospital-wide mortality (by January 2010);
•    Update and expand the public reporting of quality and cost information; and
•    Build consumer understanding of the quality and cost website and how to use it.