A Look Back at the Patrick Administration: Eight Years of Health Care Leadership

January 6, 2015 § Leave a comment

By Melissa Shannon, Director of Government Relations and Public Affairs, Commonwealth Care Alliance

This time of year, year-in-review articles are a dime a dozen. While we seek to burn off our holiday indulgences at the gym, we see and hear no end of stories about the best restaurants that opened, the best ones that closed, the most memorable celebrity extravagances, the biggest political gaffes, and other entertaining year-end trivia. But, in health care in Massachusetts, we are experiencing something much more significant – the end of an important chapter in health care policy with the departure of Governor Deval Patrick. It is appropriate that we take stock in all that has been accomplished in his tenure and give thanks where thanks are due.

Governor Patrick was elected eight years ago on a wave of unprecedented grass-roots populism. “Together We Can,” brought new engagement from younger and more racially diverse voters and a surge of optimism about what could be accomplished with such a populist leader. Nowhere was that optimism more palpable than in health care policy. We already had much to be grateful for with the passage the year before of “Chapter 58,” Massachusetts’ landmark health care expansion law, and decades of strong and effective health care consumer advocacy.

But, Governor Patrick had made it clear from the earliest stages of the campaign that he was committed to the principle of health care as a human right and to making the health care system affordable and effective for consumers first and foremost. As Patrick said in 2006, “I see health care as a common good – like clean air, safe streets, and effective education – and so I believe that government has a role to play in assuring that the conditions exist for the health care system we all want.”

Governor Patrick and his capable team of health care loyalists (more on them in a minute) wasted no time in implementing Chapter 58 to the greatest benefit of the health care consumer at every opportunity. That commitment led to over 96% of Massachusetts residents being insured, 252,000 new MassHealth members in 4 years, with 61,000 of those eligible because of the eligibility expansions. It also led to subsidized, comprehensive, easy-to-understand coverage for 175,000 through the Massachusetts Health Connector. Massachusetts, in months, created an effective model that the nation is still attempting to replicate.

Also to his credit, Governor Patrick spearheaded, pushed for, and signed comprehensive payment reform legislation in 2012. Chapter 224, as it is known, created the Health Policy Commission to set annual health care spending benchmarks, increase transparency in health care expenditures, monitor health care mergers and acquisitions, and set exemplary standards for patient-centered medical homes and accountable care organizations. This unique approach to a nation-wide problem – the rate of growth in health care expenditures – is again serving as a national model.

At Commonwealth Care Alliance, we are very involved with what is arguably one of this administration’s greatest achievements: the launch of the duals demonstration, known in Massachusetts as One Care. The administration’s eagerness to pursue a better way to serve the sickest and poorest among us led to Massachusetts being the first state to design and implement an integrated care and financing model for those eligible for Medicare and Medicaid.

One Care enrollment opened in October of 2013, and, as of November 1, 2014, there were 18,104 enrollees, 10,005 of them with Commonwealth Care Alliance. For many enrollees, this change has brought – for the first time in their lives – quality, coordinated care tailored to their needs.  (Click here for a testimonial from a One Care member.)

The program is not without its challenges, but there is no question that One Care has provided an opportunity that is transformative for the people who avail themselves of it and for the health care system we work within. Once again, Massachusetts has set an example for the nation to follow, the full impact of which will not be fully realized until years after Governor Patrick has left the corner office.

Governor Patrick and his team’s tenure as health care advocates in-chief is also notable for what it did not deliver. The optimism that elected Governor Patrick met fierce reality less than a year into the first term when the great recession hit. Severe spending cuts throughout state government became necessary. In a Commonwealth where health care expenditures make up over a third of the budget, you would expect a proportionate degree of health care cuts. But, MassHealth benefits went almost entirely untouched because of the Governor’s commitment to maintaining comprehensive health care services to people of limited means. That is not to say that the recession was not painful, with many providers and MassHealth insurers having to do more with less, and the impacts of the lack of investment in administrative resources are still being felt. But, it could have been so much worse. One need only be a fly on the wall at any national Medicaid directors or advocates’ conference to know how good we have it here.

So, as Governor Patrick prepares to take his “lone walk” on Wednesday evening to depart the State House for the last time as the sitting Governor, it is fitting that we take a moment to say thank you to him and his team. That team includes Dr. JudyAnn Bigby, who served as Health and Human Services Secretary for five of the most challenging years in the agency’s history; John Polanowicz, who succeeded her as Secretary and saw the duals demonstration to fruition; Medicaid Directors Tom Dehner, Terry Dougherty, Julian Harris, and Kristin Thorn, each of whom served about two years in what has to be one of the most difficult and thankless jobs in state government. Thanks also to countless others, some of whom will be staying on and some who may not, including Robin Callahan, Corri Altman Moore, Sharon Hanson, Sharon Boyle, Ken Smith and so many others. Massachusetts health care consumers are better off in credit to your service, and our health care system has transformed to a better place. Our outlook is bright. Thank you.


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