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Could Mass. health trust have national impact?

The 2006 Massachusetts healthcare reform law requiring residents to have health insurance is widely recognized for laying the groundwork for President Obama’s Affordable Care Act. Now, a Northeastern University report offers a comprehensive examination of another state health initiative focused on cost prevention that could again become a model replicated across the U.S.

The white paper, prepared by Northeastern’s Institute on Urban Health Research and Practice, examines a Massachusetts initiative that takes an alternative approach to supporting public health programs: the Massachusetts Prevention and Wellness Trust, a four-year, $60 million project designed to support prevention and health promotion activities and gather evidence on the cost savings achieved by these activities.

The report’s primary author is John Auerbach, the institute’s director and a Distinguished Professor of the Practice in Northeastern’s Bouvé College of Health Sciences. The paper was funded and released by the Robert Wood Johnson Foundation, a philanthropic organization focusing on issues critical to health and healthcare in the United States.

John Auerbach, director of the Institute on Urban Health Research and Practice and Distinguished Professor of the Practice in the Bouvé College of Health Sciences, is the report primary author. Photo by Brooks Canaday.

John Auerbach, director of the Institute on Urban Health Research and Practice and Distinguished Professor of the Practice in the Bouvé College of Health Sciences, is the report primary author. Photo by Brooks Canaday.

Established in July 2012 by the state legislature, the Massachusetts Prevention and Wellness Trust stems from a cost containment bill that followed the commonwealth’s landmark 2006 legislation. The trust will fund between six and 12 community-based partnerships that provide research-based interventions that can reduce rates of the most prevalent and preventable health conditions; increase healthy behaviors; address health disparities; and increase the adoption of workplace-based wellness or health management programs.

The white paper notes that traditional approaches to supporting public health activities—namely with government funds for disease-specific programs—are struggling because of funding cuts and are unlikely to improve in the near future. It cites the trust as one of several novel experiments underway across the country seeking to identify innovative methods that support public health activities.

“People in Washington are now looking to whether this latest Massachusetts initiative is something that can be replicated nationally or in other states,” said Auerbach, who is the Massachusetts’ former health commissioner.

The trust was funded through a one-time assessment on Massachusetts’ largest insurers and hospitals, and, according to the report, the money will be “distributed to innovative collaborative teams who want to improve health outcomes through community change and linking clinical providers with community partners.”

The extensive report comprises a review of six years worth of healthcare and payment reform legislation. It includes an overview of the trust; the groundwork laid for its passage and the issues raised by the legislation during that time; feedback from the key individuals and groups who secured its passage; preliminary lessons other states can learn from Massachusetts’ approach; and several case studies.

The authors noted that by understanding the funding, structure, and priorities of the trust, other states could identify places in their own budgets and healthcare infrastructure that will allow them to form similar initiatives. The implications of these findings, they wrote, go far beyond reduced healthcare costs; they could also provide a framework for marshaling a state’s multitude of resources—including hospitals, health practitioners, community health centers, universities, and food assistance organizations—to improve the long-term health of the entire population.

The report, as Auerbach put it, analyzed the trust’s potential value to achieve the “triple aim of better health outcomes, better quality of care, and lower costs.”