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CHIA good source of data about Mass. healthcare

The center for health information and analysis produces reams of data for both Massachusetts policymakers and the public, providing a window into state health care expenditures and offering tools to compare prices between different providers.

Ray Campbell, the executive director of CHIA, walked through some of the available online data tools during a recent conversation with Paul Hattis and John McDonough for their “Health or Consequences” Codcast.

“No other state has an organization quite like CHIA,” said Campbell, who added that the agency, which is funded by assessments on the health care industry, looks into spending on hospitals, drugs, and doctors, and it gains some important insights from the all-payer-claims database.

While CHIA has access to tools that are unavailable in other parts of the country, the agency can’t see everything, so it works collaboratively with the health insurers to give consumers a more complete idea of what they might pay for a particular procedure.

Putting standardized testing to the test

With spring comes the annual ritual of MCAS testing in Massachusetts schools. It’s how we gauge the performance of individual students as well as schools and districts. The assessment of basic skills in math, English, and, more recently, science offers a snapshot of academic achievement levels, and it is the central measure used in the state’s accountability system that aims to hold schools responsible for outcomes.

And, argues Jack Schneider, it fundamentally gets everything wrong.

The UMass Lowell professor wrote in his recent book, Beyond Test Scores: A Better Way to Measure School Quality, “We have two decades of evidence that current approaches to educational measurement are insufficient and irresponsible.”

Schneider says on this week’s Codcast that test scores serve only as “demographic data in disguise,” telling us more about the family income of students than about the quality of their education.

He’s part of a cohort of critics who say the testing and accountability systems that have accompanied the modern education reform movement have served to narrow the curriculum — particularly in schools serving lots of poor kids. Test scores, he says, tell us nothing about how safe students feel, whether they are “developing as citizens,” and whether they feel engaged by school.

Dogged advocate for putting more bodies on trains

In the world of transit advocacy, there are those who push for sweeping changes such as regional rail, connecting the Red and Blue subway lines, or doing away with transit fares. And then there are people like Richard Prone, who advocates for smaller, nitty gritty initiatives that nevertheless play an influential role in the broader debate.

Prone spent most of his working life as a train engineer and now, in retirement, serves as the Duxbury representative on the MBTA Advisory Board. He is a relentless advocate for the South Shore at meetings of the T’s Fiscal and Management Control Board, where he shows up week after week during the public comment period and uses his two minutes of speaking time to doggedly make the case for policies he believes will help his neighbors and increase commuter rail ridership.

“You have to be persistent and you have to make sense,” he said on the Codcast.

Episode 152: Putting out a welcome mat for housing

Greater Boston’s booming housing market may be lucrative to real estate speculators, but the constricted supply of housing isn’t helping those who make long-term investments in their homes, according to a Boston city councilor and housing advocates.

Councilor Lydia Edwards, who chairs the Housing and Community Development Committee and represents East Boston, Charlestown, and the North End, said that if housing production (including affordable housing production) rises to a rate that better meets demand, speculators might be hurt but ordinary homeowners will gain a more long-term perspective on their investments.

“What we’re seeing is an inflation of that value and people buying in like it’s the new stock market in order to get a return that is just unheard of even on Wall Street on housing that they’re not occupying or even – sometimes – renting out,” Edwards said. “If that’s your goal, to make that kind of return on your investment, yes, building a lot more units might actually hurt that.”

Edwards joined Chris Norris, executive director of Metro Housing Boston, and Eric Shupin, the director of public policy for the Citizens Housing and Planning Association, on the Codcast.

Episode 151: Slowing down the ‘stroads’ of Boston

Boston’s version of vision zero, an idea that originated in Sweden more than two decades ago, sets as its target zero fatalities or serious injuries by 2030 among people who walk, bicycle, or drive.

A recent policy report from the Vision Zero Coalition indicates the number of fatalities has been declining in Boston, falling from 21 in 2016 to 10 in 2018, with the number of pedestrian fatalities dropping from 14 to 7 over that time period. But the number of crashes that required response by emergency medical service teams actually increased slightly, rising from 4,355 in 2016 to 4,367 in 2018.

“Generally speaking the trend lines are better, or at least they’re not any worse, than when the program was adopted,” said Matthew Lawlor, who is active in WalkUP Roslindale. “We’re making progress, but those of us who are advocates think progress isn’t coming fast enough.”

Episode 150: Health care chairs vow action on price variation

The co-chairs of the Legislature’s Joint Committee on Health Care Financing may be new to their posts, but both seem to grasp the urgency of tackling big issues facing the state’s health care sector and both sound optimistic about solutions to some thorny problems emerging in the current session on Beacon Hill.

That’s the takeaway from a conversation with Sen. Cindy Friedman and Rep. Jennifer Benson convened by Paul Hattis and John McDonough as part of their “Health or Consequences” interviews on The Codcast.

One of the biggest issues looming over the health care sector: the large price variation in what hospitals charge for similar services, a problem that vexed lawmakers last session, as they adjourned without reaching agreement on an approach to dealing with it.

“This is a very, very, very big issue, and it is not something that we’re going to be able to skirt if we really are going to address health care costs,” said Friedman. She said there’s a need to address issues “at both ends of that spectrum” — dealing both with the much higher costs charged by big teaching hospitals while also making sure community hospitals aren’t bringing inefficiency to the overall system by trying to add costly services already provided elsewhere.

Episode 149: Baker increasingly isolated on transportation taxes

Gov. Charlie Baker finds himself increasingly isolated on Beacon Hill with his opposition to new revenues for transportation.

House Speaker Robert DeLeo and Senate President Karen Spilka are both open to raising additional revenues for transportation and the two chairs of the Legislature’s Transportation Committee, in an interview on the CommonWealth Codcast, said new money is desperately needed.

Rep. William Straus of Mattapoisett said his first priority this session is developing a revenue package with money dedicated for transportation along with a list of spending priorities for the future. He said lawmakers don’t like to increase taxes, so the revenue option chosen will be “the one people hate the least.”

“For me,” he said, “it’s hard to see the kind of revenue in the kinds of numbers we’re talking – hundreds of millions of dollars – that isn’t built at least as a core component of a gas tax change.” He said raising the gas tax is efficient and relatively straightforward, with each penny increase in the tax raising $35 million a year.

Episode 148: New voices, proposals emerging in Boston’s biz community

Winds of change are starting to blow through Boston’s business community.

One clear signal came earlier this month, when close to 20 business organizations said they would heed an appeal from House Speaker Robert DeLeo to help develop a transportation policy that likely will call for additional revenues. “It’s time for a united voice from the business community that can be a powerful driver of progress,” said Jim Rooney, the CEO of the Greater Boston Chamber of Commerce.

On the issue of climate change – and what to do about it – the folks at the Environmental League of Massachusetts say business community attitudes are also changing on climate change. League officials offered up for the CommonWealth Codcast three business leaders who reflect that change — Cynthia Curtis, senior vice president of sustainability at the commercial real estate firm JLL; Kyle Cahill, director of corporate responsibility at John Hancock; and Tedd Saunders, chief sustainability officer at the Saunders Hotel Group.

“For a long time, legislators were only hearing from industry representatives and businesses that said this legislation or that policy is going to be bad for business – we’re going to have to lay off people and costs will go up,” said Saunders.

Episode 147: When muskets defended the editorial page

Much has changed in the national discourse since a pro-war rabble two centuries ago tore down a Baltimore newspaper building, besieged the paper’s editor, and later broke into the city jail to attack him yet again.

But while legal and conventional structures have been erected to protect a robust free press, the baying mob hasn’t exactly gone away, according to Justin Silverman, executive director of the New England First Amendment Coalition, and Rep. Josh Cutler of Duxbury, author of the new book Mobtown Massacre: Alexander Hanson and the Baltimore Newspaper War of 1812.

The two appeared on the Codcast to talk about the violence that followed Alexander Hanson’s decision to publish an anti-war editorial, and to then double-down with another screed after political opponents tore down his newspaper building.

“I was struck on many occasions with the parallels today,” said Cutler. “We owe some of the liberties that we see today because folks like that literally put their lives on the line to defend the freedom of the press.”

Episode 146: A health care leader from the grassroots

Community Health Centers often have a strong grassroots connection to the neighborhoods they serve. But no center may proclaim that more loudly through its leadership than the East Boston Neighborhood Health Center. Its president and CEO, Manny Lopes, is a native son of Eastie whose first job after high school was as an 18-year-old field researcher at the nonprofit health care center.

He now not only leads the neighborhood health center, he’s emerging as an important health care leader in the city and state. In December, Lopes was named chair of the city’s Board of a Health, which oversees the Boston Public Health Commission, and he also serves as chairman of new collaboration among 17 health centers statewide that is part of a big state Medicaid initiative that is trying to deliver better quality care at lower price.

Lopes, appearing on the latest episode of the “Health or Consequences” Codcast, said the Medicaid effort to test the impact of “accountable care organizations” is promising, but still unproven. “We’re still waiting for the data and we’re still early in the process,” he told hosts John McDonough of the Harvard Chan School of Public Health and Paul Hattis of the Tufts School of Medicine.