Massachusetts Medical Society: High Deductibles: What They Mean for Patients and Physicians

High Deductibles: What They Mean for Patients and Physicians



New MMS report on the impact and implications of high-deductible health plans

The MMS has published an informational report on the prevalence and impact of cost-sharing, particularly high-deductible health plans, in Massachusetts. Assessment of the Impact of High-Deductible Health Plans on Patient Health and the Financial Impact on Medical Practices is designed to guide physician policy and advocacy efforts at the state and federal levels. The report outlines policy options that could help protect patients and physicians from further growth in cost-sharing, encourages conversations between physicians and patients about costs, and promotes advocacy for more equitable and durable means of controlling medical spending. The impact of cost sharing on patients and physicians is also explored in the Summer issue of Vital Signs: Patients are Feeling Crushed By Health Care Cost Sharing: How Can Physicians Be Part of the Solution? (Illustration: Chris Twichell, MMS)

New MMS resource on drowning prevention and water safety

Summer is here, and people are flocking to the water. More than 3,500 people in the US die in drowning accidents each year, most of them in May–August. In children aged 1–14 years, drowning is the second leading cause of unintentional death. The MMS has produced a new guide for patients and parents to inform and remind them of the dangers of drowning. This downloadable resource for providers and patients addresses drowing prevention, what to do in an emergency, and where to find further resources and training.

Independent reports anticipate significant reductions to MA health insurance coverage and increased costs under AHCA or BCRA

Reports from the Robert Wood Johnson Foundation and the Urban Institute predict state-by-stage changes in coverage and spending if the ACHA (passed by the House of Representatives) or BCRA (being considered in the Senate) become law. State-by-State Coverage and Government Spending Implications of the Better Care Reconciliation Act anticipates that passage of the BCRA would result in 109,000 people in Massachusetts losing health coverage, mostly from the nongroup insurance market, and estimates that the Commonwealth would have to increase its own spending by 14.2 percent to maintain the Medicaid expansions. The Impact of the AHCA on Federal and State Medicaid Spending and Medicaid Coverage: An Update predicts that Massachusetts could see substantial reductions in coverage —including a 26 percent reduction in nonelderly Medicaid enrollment—in order to maintain current state spending on pre-ACA eligible populations.

Massachusetts makes progress on prescription opioids

Prescription opioid use may be falling more quickly in Massachusetts than in other states, a new report from Blue Cross Blue Shield suggests. According to the Health of America report:

  • Fourteen percent of Blue Cross members in Massachusetts filled an opioid prescription in 2015, compared to 21.4 percent nationwide
  • Two percent of MA members received high-dose, long-duration opioid treatment in 2015, the second lowest in the country; nationally, 8.3 percent of members received this treatment, which is associated with higher rates of opioid use disorder
  • 6.1 in every 1,000 MA members were diagnosed with an opioid use disorder in 2016, compared to 8.3 per 1,000 members nationwide
  • Eighty-four percent of MA members who were diagnosed with an opioid use disorder in 2016 received medication-assisted treatment, the second highest nationwide

The MMS is working to address the opioid epidemic through opioid prescribing guidelines and has trained more than 10,000 providers on opioid prescribing, in addition to advocating for partial-fill legislation and the mandatory use of MassPAT, the state’s prescription drug monitoring program. Read more about the Blue Cross report (Boston Business Journal).

Reminders! MACRA, RPBO, and more

AMA video shows physicians how to avoid Medicare payment penalties

The AMA and the MMS are looking to help physicians avoid a negative Medicare payment adjustment in 2019—an effort that may be particularly relevant to physicians who have not previously participated in Medicare reporting programs, and/or physicians in smaller practices. The AMA has  new materials available on its website, including:

  • A short video: One patient, one measure, no penalty: How to avoid a Medicare payment penalty with basic reporting.
  • A sample CMS-1500 claim form
  • Links to quality measures on the CMS website
  • A link to the CMS MIPS eligibility tool

Free personalized assistance from MMS for practice MACRA/MIPS strategies

Join us for FREE personalized assistance in developing your strategy for MACRA MIPS implementation in your practice. The program includes Mapping out MIPS: Keys to Success in 2017, which outlines measure selection and reporting requirements. It is designed for providers who are MIPS eligible and required to report for 2017 ( check MIPS reporting requirements). Space is limited. Dinner is provided. The session will be led by Yael Miller, MBA, Director of Practice Solutions & Medical Economics at MMS, and Leila Volinsky, MHA, MSN, RN, Program Administrator at Healthcentric Advisors. Healthcentric Advisors is a CMS contracted organization and supports practices of all sizes in preparing for MIPS implementation. They have been helping hundreds of clinicians prepare for MACRA, and want to help you.

Two sessions will be held—July 11 or July 27, 2017, 5:30-8:00 p.m.—at MMS Headquarters, Waltham (participants need attend only one session); register here. Your registration should include at least one clinician and one colleague/team member responsible for reporting. Questions? Please email Justin Sacramone at or Yael Miller at

Join the QPP Open Call sessions for expert guidance

Join the New England QIN-QIO's Quality Payment Program (QPP) team as they review frequently asked questions about participation in the Merit-based Incentive Payment System (MIPS) or an Alternative Payment Model (APM). These calls will include time for open discussion and sharing about all things QPP. The calls are open to providers, clinicians, office managers, practice administrators, quality improvement specialists, and anyone else who is involved in quality program reporting. Calls will be offered bimonthly on the following dates, 11:30 a.m.—12:30 p.m.:

  • Wednesday, July 12
  • Wednesday, July 26
  • Wednesday, August 9
  • Wednesday, August 30

Sign up for calls here. An email with instructions will be sent the day before the call. Questions? Contact Leila Volinsky at

MassHealth ACO providers need RBPO certification: Learn the process

Find out whether or not RBPO certification applies to you. This one-hour webinar is designed to help carriers and provider organizations learn the Risk-Bearing Provider Organization certification process that relates to the development of MassHealth ACO contracts. The webinar, by the Division of Insurance, answers these questions:

  • Which entities currently have Risk Certificates?
  • Do related provider organizations need to obtain a new RBPO certificate?
  • What’s the process for organizations to file?
  • What’s the process for the Division to review applications?

How to participate:

  • Webinar: Thursday, July 6, 2017 (1PM to 2PM); join the meeting
    • Meeting number 622 364 129
    • Meeting password Vm9TMf9d
    • Also dial 1-877-820-7831 and enter Participant Code 627192 to join the call that will be part of the webinar
    • To join from a video system or application, dial

Questions? Contact Niels Puetthoff at or (617) 521-7326, or Kevin Beagan at or (617) 521-7323.

Honors, accolades, appointments, publications? Share your news in Vital Signs

Vital Signs, the monthly print and online newsletter of the MMS, has two new columns—and we need you to fill them. Members on the Move lists your professional news, such as joining a new hospital, opening a practice, or a recent promotion. Honors and Accolades is where we share your other achievements: board appointments, speaking engagements, community outreach, or published works. We are currently seeking submissions for the September issue of Vital Signs. Please include your full name and title, medical school with graduation year, residency institution, hospital affiliation, recent update, and a high-resolution headshot. Send submissions to by July 10, 2017 (for the September issue). 

Educational programs and events

Unless otherwise noted, all events are held at the MMS Headquarters, 860 Winter St., Waltham, MA. View our full calendar of upcoming live CME activities. 

Norfolk County Safe Prescribing and Dispensing Conferences
Thursday, September 14, 2017, 8:00 a.m. – 3:30 p.m.
Randolph, MA
Open to all Norfolk County registered prescribers and pharmacists

The above activity has been approved for AMA PRA Category 1 Credit™ 

Featured new online CME activities – Risk Management credit 
Comprehensive Cannabis Curriculum (Modules 1–5 now available)

The above activities have been approved for AMA PRA Category 1 Credit

See our full listing of risk management online CME activities.

This week in health care

Sign up for daily roundups of health news affecting Massachusetts.

Marijuana in MA: Here's what you need to know about the potential changes to the new law Behind closed doors, Massachusetts lawmakers are scrambling to change the new marijuana law. The main questions are how many changes they plan to make and how big they go in overhauling or tweaking the voter-approved law.

Medford hospital sharply cutting inpatient services
Many community hospitals have struggled to turn a profit and stay competitive in the changing health care industry, and Hallmark, with its hospitals located just north of Boston, faces acute competition from the many brand-name academic medical centers.

Insurers drop out of state exchanges
Massachusetts is among the states with the highest participation of insurance plans in state exchanges, with more than three carriers offering plans through the Massachusetts Health Connector.

GE & Partners opioid effort Rize gets new executive director
The organization will release its first request for funding proposals in the fall, looking for opportunities to fund ideas and technologies that address everything from prevention to treatment to long-term sustainable recovery.

WBUR poll finds sharp increase in concern about climate change among Mass. voters
The big worries among those polled in Massachusetts are all up significantly: three-quarters say they're concerned that in the coming decade the state will experience coastal flooding, extreme heat waves, and sea level rise as a result of climate change. And 82 percent fear Massachusetts we'll be hit by more powerful storms.

More than quarter million in MA could lose health care under Senate proposal, says Gov. Baker
In addition to 264,000 people potentially losing their health insurance, Baker said the state would be lose $907 million in 2020 and face a cumulative financial impact of $8.2 billion by 2025.

Mother shares $231,115 bill after son's open heart surgery at Boston Children's Hospital amid national health care debate
Ali Chandra shared the bill from her son's latest surgery she said to make a point regarding national healthcare debates and to speak against caps on medical costs.

Boston Children's tops U.S. News' list of best children's hospitals
The report placed Boston Children's atop this year's Honor Roll, which singled out 10 hospitals that excelled in the 10 specialties on which pediatric centers were evaluated. Boston Children's ranked No. 1 in five of the 10 specialties.

Minuteman Health shifting to for-profit status
Minuteman was created under a program of the Affordable Care Act that was designed to offer lower-cost insurance options for individuals and small businesses. About two dozen such insurers were launched with $2.4 billion in federal funds — including $156 million for Minuteman. Many of the insurers struggled and shut down. One insurer in Maryland recently converted to a for-profit

In internal memo, nurses union says strike should hurt Tufts Medical
Contract discussions between union nurses and Tufts Medical Center have grown contentious, with union leadership saying in an internal memo and in Facebook posts that they want to pick a strike date that is "most harmful to the hospital."

Baystate Franklin nurse strike begins with Sunday lockout
In anticipation of 200 union nurses at Baystate Franklin Medical Center launching a strike Monday morning, the hospital began a lockout of those nurses on Sunday night.

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