Health care leaders identify problems, solutions for Healey

Staffing, costs, mental health tagged as key issues

IT’S THAT TIME of year again, when advocates gearing up for a shift in state administrations are laying out their policy goals.

The latest report, released Thursday, comes from interviews with a wide range of health care organizations, convened by the Blue Cross Blue Shield of Massachusetts Foundation, a nonprofit attached to the insurer, and consulting firm Manatt Health. The report, which seeks to set goals for Gov.-elect Maura Healey, highlights some of the biggest issues confronting the health care industry right now.

“With the new administration taking shape on Beacon Hill, our goal is to encourage action on today’s most pressing health care challenges,” said Audrey Shelto, president and CEO of the Blue Cross Blue Shield of Massachusetts Foundation.

Since Massachusetts became the first state to pass a universal health insurance law, the state has led on access, but lagged in affordability with some of the nation’s highest health care costs. Lawmakers and outgoing Gov. Charlie Baker have for years been proposing ways to bring costs down but have failed to reach agreement. Unsurprisingly, affordability is one of five issues flagged by the health care leaders.

Among the proposed solutions: increasing the income eligibility level at which someone can get subsidized Health Connector insurance; creating a health insurance program for low-income immigrants who lack legal status; and doing more outreach to get people who are eligible for state-subsidized coverage enrolled. The report also recommends giving the Health Policy Commission more authority to control prices, including by setting provider price caps, a controversial proposal that would limit how much hospitals and clinicians can charge.

Another long-standing issue is a lack of affordable long-term care, like nursing home care, which is often not covered by health insurance. The report says solutions could include creating a state-sponsored individual contribution program to encourage people to save for long-term care, expanding state oversight of rate-setting for long-term care insurance, and encouraging people to buy private long-term care insurance, potentially with the creation of a program providing public assistance once people exhaust those benefits.

One area of health care that has become an increasing crisis during the pandemic is children’s mental health. Anxiety and depression jumped during COVID lockdowns, while disrupting the availability of services for children who needed care. The Baker administration already laid out a road map for improving behavioral health care, and the report has fewer concrete recommendations in this area. Its suggestions are mainly about crafting long-term strategies and partnerships to address the problem.

The pandemic also highlighted long-standing racial inequities in health. The report’s authors seek to create a new cabinet-level Office of Equity in state government, with offices in each secretariat aimed at addressing equity issues, which in health care would include topics related to insurance coverage, access, quality, consumer experience, and outcomes.

Finally, staffing shortages in health care have become a crisis, as all industries struggle to find labor and health care clinicians struggle with burnout after three years of a pandemic. The report says a crucial step will be raising wages for behavioral health clinicians and long-term care workers, and developing a 10-year plan focused on recruiting and retaining workers, stabilizing wages and benefits, and increasing diversity.