UMass Medical School’s Center for Health Policy and Research is engaged in a number of evaluation, research, and training projects that have a significant impact on current public health issues. The listing below is just a partial look at some of the programs, policies, and initiatives that are making news around the country. Click the links to see how the Center’s work is effecting real change, from the bedside to the community.
Pay for Performance
There is a growing trend, nationally, to tie Medicaid reimbursement rates to performance and quality benchmarks, such as HEDIS scores. Providers who do not meet benchmarks or do not show improvement risk losing their reimbursements, which could have a profound effect on their bottom lines.
Health Information Technology Policy
Federal programs such as Medicaid are driving adoption of electronic medical records as a quality goal, but implementation is new — as well as difficult and costly, with no single set of standards among providers and payers.
Health Care Cost and Utilization
The global economic slowdown has had an immediate and deep effect on public health care programs across the state, making the economics of each program come under increased scrutiny. Medicaid programs will be looking for better, more cost effective ways to achieve access and quality goals.
Promoting health and preventing health problems are arguably the best ways to contain health care costs, but it is difficult to show return on investment (ROI). Health care payers are looking for measurable results on how to promote healthier lifestyles at the lowest cost.
Buprenorphine is an alternative to methadone treatment for opioid addiction but is seen as expensive. Massachusetts, one of the few states to experiment with buprenorphine treatment, has found it to be successful in many ways. The drug is about to come off patent, which could help lower its expense and increase interest in it as a treatment, especially if generic alternatives are developed.
Pharmacy Online Processing System
The MassHealth Pharmacy Online Processing System (POPS) is a software system that provides real-time submission and approval of claims, as the prescription is entered at the subscriber’s local pharmacy. The system checks for up to 350 different conditions, and is considered one of the most robust and sophisticated in the nation.
Medical Interpreter Training
The U.S. is increasingly a nation of multiple languages; Central Massachusetts in particular is a national refugee relocation center. The wide range of cultures and first languages is driving the need for interpreters with specialized medical knowledge and training.