4 HEALTH • Winter 2017
C E N T R A L M A S S A C H U S E T T S
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HEALTH Editor
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A division of:
HEALTH
{ From The Editor }
H
ealth insurance is a hot topic in the United States, but it's a
difficult one for the public to digest. When I was a reporter for
the Sentinel & Enterprise, based in the Leominster bureau about
six years ago, I was faced with the challenge of writing about it in
some depth for the first time.
I was reporting on the bleak financials of UMass Memorial HealthAlliance
Hospital (now UMass Memorial HealthAlliance-Clinton Hospital). Patrick
Muldoon, who was CEO of HealthAlliance at the time, gave me a crash course
in health insurance reform, and how this was impacting the bottom line of
most hospitals.
Muldoon told me we were on the cusp of a sea change in how healthcare providers were paid,
getting away from a system paying doctors every time a patient gets sick, and toward one holding
them responsible for keeping patients healthy, on budget. I was overwhelmed, to say the least, but
Muldoon assured me this was to be expected, since there were reporters at larger newspapers who
spent all of their time covering only health care.
Fast forward to today, and that's basically true for me. Muldoon is about to retire from his post as
president and CEO of UMass Memorial Medical Center (see Page 5), to which he was promoted in
2013, and the state Medicaid program, MassHealth, is about to implement the very system Muldoon
foretold for close to half of its nearly 2 million members.
These events converged in time for our Winter issue of Central Massachusetts Health, which
focuses on health insurance, as well as women's health, and I was excited to write about how the
formation of accountable care organizations (ACOs) to manage the health and cost of care for
MassHealth patients has the potential to improve care through better coordination. There's definitely
a downside risk to providers, which can lose money if they don't meet the goals of their contracts,
but the potential for improving health care and eliminating waste within the very expensive
MassHealth system – the single largest piece of the state budget every year – is great. Meanwhile,
patients will see their care managed with more thoughtfulness for their particular situation.
While sources told me accountable care has been slower to catch on than expected among
commercial insurers for a number of reasons, the MassHealth transition effective March 1 will no
doubt set an important example for federal and commercial insurance payors, in Massachusetts and
across the country. Given the burden health insurance is to people, employers and state budgets,
here's hoping it goes off without a hitch.
- Emily Micucci, HEALTH editor
In Massachusetts,
an insurance revolution arrives
Central Massachusetts HEALTH is published 4
times a year by New Engand Business Media LLC.
