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Anita Walker betting culture is good for your health

With a portion of the state’s casino revenues, the Massachusetts Cultural Council is testing whether arts and culture can be prescribed just like medicine.

The organization is running three pilot projects where health providers, counselors, and social workers prescribe cultural activities for those with whom they work. The goal is to see whether going to the zoo, visiting a museum, or attending the symphony can have beneficial health impacts.

Anita Walker, the executive director of the Cultural Council, is convinced the experiment will work, in part because the health benefits of cultural activities have been documented in a number of studies. She’s using a portion of the revenues her agency receives from casino gambling to pay the cost of the pilot project prescriptions, but in the long run she hopes health insurers will come to see the health benefits of arts and culture and pick up the tab themselves.

“Maybe we can find a way to convince insurance companies that this is a good investment because it will save money,” Walker said on The Codcast from CommonWealth magazine. “You know insurance companies will pay for your gym membership. Insurance companies will give you a benefit if you don’t smoke. If they can see the benefit of cultural participation as a protective factor and a prevention against much more expensive consequences, maybe we can find another resource stream for our organizations.”

Walker says one of the chief benefits of arts and cultural activities is a feeling of participating in something bigger than oneself. “You can’t pick up a newspaper without reading about the epidemic of social isolation and loneliness, which leads to depression and even serious, serious physical health conditions like heart disease. I read recently that social isolation and loneliness have the same impact on your health as smoking 15 cigarettes a day,” Walker said.

Tunneling under the Charles River

As state transportation officials prepare to replace the elevated section of the Massachusetts Turnpike that runs between Boston University and the Charles River, they are facing an age-old problem – whether to strive for the absolute best approach or whether to pursue what’s best under the circumstances.
The challenge, and the tradeoffs involved, were explored on the Codcast by two transportation experts  who are well aware of the high stakes involved – Antonio Di Mambro, a visionary architect and planner, and Glen Berkowitz, project manager at A Better City.

Both Di Mambro and Berkowitz recently submitted comments to the state on the current plan for the Turnpike project, which calls for replacing the elevated portion of the highway, which is 60 years old and falling down, and addressing a host of transportation issues in the Allston I-90 area.

The state’s current plan is to put the Turnpike, two railroad lines, and a pedestrian and bike path at ground level and run Soldiers Field Road above. After years of insisting the Charles River should not be touched during construction, state officials have also concluded that they need to temporarily run Soldiers Field Road and the bike and pedestrian path out over the Charles River during the estimated 10-year construction period.

The potential impact on commuters of this project could be immense. During construction, the Turnpike will have six lanes instead of eight and the Worcester commuter rail line may be periodically reduced to one track in the area.

TransitMatters 2019 Retrospective

SOME OF THE STATE’S leading transit advocates are calling for extending the life of the existing MBTA Fiscal and Management Control Board for six months to a year and making buses free across the state.

On the TransitMatters Codcast hosted by CommonWealth magazine, Jim Aloisi, the former transportation secretary and TransitMatters board member; Josh Fairchild, the co-founder and president of TransitMatters; and Stacy Thompson, the executive director of Livable Streets, looked back at 2019 and forward to 2020. They predicted the Legislature would pass a transportation revenue package and assembled a wish list of fairly predictable initiatives they would like to see action on.

Partners vowing to end surprise billing

Partners HealthCare is moving to eliminate surprise billing, where consumers receive large, unexpected hospital bills after unknowingly being treated by a doctor who doesn’t accept their insurance.

The Partners policy on surprise billing surfaced during a CommonWealth Codcast interview with Lora Pellegrini, president and CEO of the Massachusetts Association of Health Plans.

“Partners has told me they are going to stop this practice,” she said. “The physicians will be either employed or contracted through Partners. That’s an important example for all other providers in this state.”

A Partners spokesman, Rich Copp, confirmed that the state’s largest hospital system is moving to eliminate surprise billing. “That’s our goal and we’re moving toward it,” he said.

Weld: ‘All of this is totally unprecedented’

As a young lawyer working for the congressional committee investigating President Nixon, Bill Weld’s job was to study every impeachment that had previously occurred in Great Britain and the United States.

Now he’s running in the Republican primary against the third president ever to be impeached by Congress: Donald Trump. He has some perspective.

“All of this is totally unprecedented. We’ve never had a president who came anywhere near this,” said Weld.

The former federal prosecutor and twice-elected Massachusetts governor visited The Codcast on Friday to share his thoughts on President Trump, the impeachment, and his campaign.

Weld plans to compete in every state where he is legally permitted to be on the ballot, and he thinks it is “looney tunes” that the Massachusetts Republican party suggested he should not be eligible for the ballot here.

Saving Hampshire College

Can Hampshire College rise, if not from the dead, from the higher ed death watch list? 

Harvard Business School professor Clay Christensen has predicted that as many as half of all US colleges and universities will close or go bankrupt over the next decade, and a year ago it looked like Hampshire would be one of them. 

The Amherst college, founded in 1970 with a commitment to rethinking traditional liberal arts education, said it was in dire financial straits and would be seeking a “strategic partner” to merge with. The college, which depends almost entirely on tuition revenue to operate, seemed to push itself closer to the fiscal cliff by then announcing it would not accept a new entering class this fall. 

The news of Hampshire’s death, however, has been premature. 

Students, faculty, and alumni rose up in protest against the planned merger, and within months the college president who said it was the only viable path had resigned, along with the leaders of the college board of trustees who backed the plan. The remaining college leaders declared they would instead mount an aggressive fundraising drive and pursue other reforms to remain an independent college.

Now charged with leading that effort is Ed Wingenbach, who arrived in August as Hampshire’s new president. For a guy facing a very tall task, the veteran college administrator — most recently at Ripon College in Wisconsin — sounded enthusiastic and upbeat as he talked about the challenge on The Codcast.  The college has about 730 students after what Wingenbach calls the “self-induced crisis” of not enrolling a new class this fall. He says Hampshire will be back to 1,100 or 1,200 students within five years.

Atrius Health reaching back to its managed roots

There’s a back to the future feel to some of the changes taking place in US health care, and Atrius Health, which provides care to some 740,000 patients, is a leading player in that effort in Massachusetts.

After years of soaring health care costs, there is growing interest in moving away from the fee-for-service model that has long dominated care, where providers are paid for each patient interaction or procedure. The trend now is toward giving health providers a set budget to care for patients over the course of a year. The idea is that it creates an incentive for providers to do all they can to maintain patient health, even if it means more spending on preventive services to prevent costlier outcomes down the road.

It harkens to the early days of managed care, when such a system was touted as a way to achieve the double-win of better health outcomes at lower cost. By the 1990s, however, HMOs were in retreat, faced with a public pounding as many big for-profit companies seemed more interested in managing costs by denying various services than promoting good health outcomes. The idea behind managed care, however, is enjoying a revival as the US health care system struggles to find ways to better coordinate care and control cost growth.

At Atrius, one of the state’s largest health networks, with more than 700 physicians and 400 non-physician providers, more than 80 percent of all revenue now comes from some sort of global payment structure that moves away from the traditional fee-for-service model.

“Which means we are directly aligned with our patients’ interests,” said Dr. Steven Strongwater, the CEO of Atrius, on this week’s episode of The Codcast. “We want to keep patients healthy and well and out of ERs and hospitals to lower their out-of-pocket costs, and to improve their outcomes, their patient experience, and safety.”  

What’s behind the split within the Mass. GOP

There is a struggle going on for the soul of the Massachusetts Republican Party between Trump loyalists who control the party apparatus and a more moderate brand of Republicanism espoused by Gov. Charlie Baker.

The state party is headed by Jim Lyons, a social and economic conservative who said in a recent email to state Republicans that President Trump’s economy is working for Massachusetts residents. “We learned on Election Day that even here in ‘blue’ Massachusetts, voters in our targeted areas are picking common sense over creeping socialism,” he said.

But the party is also headed by its top office-holder, Baker, who is no fan of Trump and practices a brand of politics that blends social liberalism, fiscal restraint, and a willingness to work cooperatively with the Democrats who dominate Beacon Hill. A relatively new super PAC affiliated with Baker spent money on behalf of Republicans and Democrats in the November municipal elections.

While Lyons and Baker refrain from attacking each other publicly, it’s clear they represent competing factions within the party. On the CommonWealth Codcast, two Republicans from those factions engaged in a sometimes testy debate about the struggle over the party’s direction.

Is Walsh preparing to go ‘bold’ on transportation?

Is Mayor Marty Walsh preparing to call for a massive upgrade of Boston-area public transit by making the case for a regional tax to support bold new investments? Listen to him on the new installment of The Codcast, and you make the call. 

The Greater Boston Chamber of Commerce’s “City to City” program sets out to take Boston civic and business leaders to other cities so they can expand their thinking on challenges at home by learning about policies and practices elsewhere. Walsh, who was part of the program’s trip earlier this month to Los Angeles, has clearly taken that mission to heart.

Appearing on The Codcast, Walsh repeatedly pointed to the “bold” move taken by Los Angeles leaders, who brought a countywide ballot question to voters asking them to raise the local sales tax to support major investments in the region’s transit infrastructure. 

“That’s a bold idea,” Walsh said of the LA ballot effort. “We have to think bold here in Massachusetts, and I don’t think we think bold enough.”

Anderson: No revenue shortage for transportation

For the Massachusetts High Technology Council, blocking a transportation revenue package is a two-step process.

The first step, which proved successful last week, was convincing House leaders to put off any action on a revenue package until next year. Chris Anderson, president of the council, argued on the CommonWealth Codcast that delaying action at least until January will give lawmakers more time to better understand the state’s revenue and political picture.

Specifically, Anderson said, the extra time will give the Legislature a chance to pass Gov. Charlie Baker’s $18 billion transportation bond bill and to determine whether the transportation climate initiative, a multistate effort to place a charge on the carbon contained in automobile fuels, is likely to become a reality any time soon. Anderson also said a delay gives lawmakers a better chance to assess the political fallout of raising the gas tax.