Sudders talks health care

State’s top health care official is ready for ‘Baker 2.0’

WHAT’S IT LIKE to be in charge of nearly half the state budget?

“Extraordinarily humbling,” said Marylou Sudders. But don’t confuse humbling with cautious indecision or lack of tenacity.

Gov. Charlie Baker’s health and human services secretary has a reputation for strong leadership and a social worker’s commitment to the enormous range of state programs she oversees, led by the Medicaid program that delivers health care coverage to 1.8 million state residents. Sudders said she is on board for a second Baker term, and highlighted some of the priorities she’ll focus on, including another stab at reining in Medicaid drug costs, an initiative to preserve access to community hospitals, and continued work to ensure access to mental health services.

Sudders said the state has built up a lot of protections against any rollback of the Affordable Care Act, but called herself a “worrier” who nonetheless closely tracks developments outside the state — prescient words on Friday afternoon, only hours before a federal judge in Texas struck down the entire federal law.

Sudders touched on those topics and more in the inaugural episode of “Health or Consequences,” a new health policy-focused entry to the Codcast line-up being helmed by John McDonough, a one-time Massachusetts legislator who now teaches at the Harvard Chan School of Public Health, and Paul Hattis of Tufts University’s School of Medicine.

Sudders expressed satisfaction with added conditions placed on the merger of Beth Israel Deaconess Medical Center and Lahey Health, but said there is a need for careful monitoring of the fact that the state health care landscape will now be dominated by two enormous players — the new Beth Israel Lahey network and Partners Health Care. “There’s no question we now have a duopoly,” she said. “I think we now have this obligation to measure the impact of what does it mean to have two strong systems in terms of trying to constrain prices.”

Sudders called a small decrease in opioid overdose deaths “a slight trend in the right direction,” but said it is hardly grounds for “a victory lap.” What she was willing to celebrate was a move, after decades of talk, to have women who are civilly committed because of addiction issues no longer held at Framingham State Prison but instead treated at “an extraordinarily strong program” at Taunton State Hospital. She also touted plans, starting in September 2019, for all county houses of correction to provide medication-assisted treatment and behavioral health services to inmates suffering from addiction issues.

She said the administration was “really disappointed” in the feds denial in June of a proposed to exclude certain specialty drugs from Medicaid coverage, where drug costs have ballooned by $1 billion over five years. “You will see next year another MassHealth pharmacy reform, 1) that guarantees access, 2) goes for direct negotiations with manufacturers, and 3) has strong consumer protections,” she said.

Sudders also said the administration will be unveiling a proposal to strengthen access to community hospitals. “This coming year, as we revisit health reform in the Commonwealth, we need to ensure that people have access to the community hospitals. I can’t tell you what that’s going to look like at this moment, but stay tuned and have me back,” she told McDonough and Hattis.

She said things have gone smoothly for the transition of 850,000 MassHealth recipients into one of 17 “accountable care organizations,” a new payment and care delivery system designed to have patients’ primary care provider coordinate the full range of their health care needs.

“Six months in, we don’t hear a lot of noise,” Sudders said of the ACO effort, which some had feared could destabilize lots of patients’ established routines.

Meet the Author

Michael Jonas

Executive Editor, CommonWealth

About Michael Jonas

Michael Jonas has worked in journalism in Massachusetts since the early 1980s. Before joining the CommonWealth staff in early 2001, he was a contributing writer for the magazine for two years. His cover story in CommonWealth's Fall 1999 issue on Boston youth outreach workers was selected for a PASS (Prevention for a Safer Society) Award from the National Council on Crime and Delinquency.

Michael got his start in journalism at the Dorchester Community News, a community newspaper serving Boston's largest neighborhood, where he covered a range of urban issues. Since the late 1980s, he has been a regular contributor to the Boston Globe. For 15 years he wrote a weekly column on local politics for the Boston Sunday Globe's City Weekly section.

Michael has also worked in broadcast journalism. In 1989, he was a co-producer for "The AIDS Quarterly," a national PBS series produced by WGBH-TV in Boston, and in the early 1990s, he worked as a producer for "Our Times," a weekly magazine program on WHDH-TV (Ch. 7) in Boston.

Michael lives in Dorchester with his wife and their two daughters.

About Michael Jonas

Michael Jonas has worked in journalism in Massachusetts since the early 1980s. Before joining the CommonWealth staff in early 2001, he was a contributing writer for the magazine for two years. His cover story in CommonWealth's Fall 1999 issue on Boston youth outreach workers was selected for a PASS (Prevention for a Safer Society) Award from the National Council on Crime and Delinquency.

Michael got his start in journalism at the Dorchester Community News, a community newspaper serving Boston's largest neighborhood, where he covered a range of urban issues. Since the late 1980s, he has been a regular contributor to the Boston Globe. For 15 years he wrote a weekly column on local politics for the Boston Sunday Globe's City Weekly section.

Michael has also worked in broadcast journalism. In 1989, he was a co-producer for "The AIDS Quarterly," a national PBS series produced by WGBH-TV in Boston, and in the early 1990s, he worked as a producer for "Our Times," a weekly magazine program on WHDH-TV (Ch. 7) in Boston.

Michael lives in Dorchester with his wife and their two daughters.

McDonough and Hattis pressed her for details of coming initiatives, but the most concrete news Sudders would offer is that she will be staying on for Baker’s second term.

The job comes with tremendous clout in state government, but Sudders said she’s always equally mindful of its limitations.

“Even with all of those resources, you realize you cannot resolve every human condition and problem that comes to you,” she said. “But what you can do is treat every issue and person that comes to you or becomes known to you with dignity and respect. That’s sort of what drives me. I take it with a seriousness I think you would want me to.”