Janett, Robert S.2013-05-022013-05-022013-01https://hdl.handle.net/10986/13292The commonwealth of Massachusetts, one of the 50 states in the United States of America, has achieved near universal health coverage of its 6.6 million residents after a landmark reform made health insurance mandatory for all residents in 2006. The reform was only the latest step in a sequence of national and state programs that successively enrolled more people in private and public health insurance programs over a period of four decades. Massachusetts passed chapter 58 of the acts of 2006, the Massachusetts health care reform law, on April 12, 2006, and over a five-year period, more than 400,000 previously uninsured residents were provided with comprehensive health benefits. As of 2012, 98.2 percent of the population is covered, including 99.8 percent of children. Massachusetts has the highest rate of health insurance coverage of any state in the country. The program has widespread popular support, and it served as a model for the design of President Obama's affordable care act, which established a plan for mandatory coverage on a national basis for the first time in the United States. This report will briefly describe the reform and its context, but will focus for purposes of simplicity on the operational details of the mass health program of health insurance for the poor. A discussion of the administration and management of Mass Health can offer a glimpse into the inner workings of all other insurance plans in the commonwealth. Mass health, private insurance, and Commonwealth Care share similar tools, controls, and strategies.en-USCC BY 3.0 IGOacademic medical centersaccess to health careaccess to health care servicesaccess to servicesacute careacute care hospitalsadministrative lawadministrative law judgeadministrative managementadolescentsadverse selectionagedagingambulatory servicesAmbulatory SurgeryAppropriate treatmentbedsblindnessblock grantblock grantsBreast cancercapita health spendingcapitationcare accesscase managementcertificationcervical cancerCliniciancliniciansclinicscommunity actioncommunity developmentcommunity healthcommunity health centercompetitive biddingcomprehensive carecost controlcost sharingcosts of carecounselorsdelivery systemdental diseasesDental Servicesdeterminants of healthdetermination of eligibilitydiabetesdiagnosisdisabilitiesdoctorselderly peopleeligibility standardseligible beneficiariesemergency careemergency roomemergency roomsenrolleesentitlemententitlement programFamiliesfamily incomeFamily planningfee-for-servicefee-for-service paymentfinancial managementfinancial penaltiesfinancial resourcesfinancial riskfinancial risksFiscal Policygroup insurance markethealth careHealth Care Costshealth care coverageHealth Care Financehealth care financinghealth care needshealth care programhealth care providersHealth Care Reformhealth care sectorhealth care spendingHealth Care Systemhealth centershealth conditionshealth costHealth costsHealth Coveragehealth educationhealth expenditurehealth expenditureshealth financinghealth financing schemeHealth IndicatorsHealth informationhealth insurancehealth insurance coveragehealth insurance planshealth insurance schemehealth insurance schemeshealth outcomeshealth planhealth plansHealth Policyhealth programsHealth ReformHealth reformshealth screeninghealth sectorHealth Serviceshealth spendinghealth statusHealth Systemhealth systemshealth workershealthcareHealthcare Providershealthcare servicesHIV/AIDSHome CareHome Health Carehospicehospice carehospital admissionhospital admissionsHospital Carehospital serviceshospital systemshospital utilizationhospitalizationhospitalshypertensionimmigrantsincentive paymentsincomeincome ceilingincome countriesInfantsinformal sectorinpatient careinpatient hospitalInsuranceinsurance companiesInsurance Planinsurance plansinsurance premiumsinterventionjudicial systemlawsmanaged caremanaged care plansmarketingMedicaidMedicaid coverageMedicaid paymentsMedical AssociationMedical associationsmedical caremedical costsmedical educationmedical equipmentmedical expensesmedical recordsMedicareMedicare beneficiariesMental Healthmental illnessMoral Hazardnational healthnational health expendituresnursesnursingNursing Home Carenursing homesoral healthoutpatient careoutpatient hospital servicesoutpatient servicespatientpatient educationpatient satisfactionpatientsPhysicianphysicianspregnancypregnant womenPrescription Drugsprimary careprimary care doctorsPrimary Care Physicianprivate health insuranceprivate hospitalsprivate insurancePrivate insurersprivate sectorProsthetic devicesProvider incentivesprovider paymentprovision of careprovision of servicespsychologistspsychosocial supportpublic costsPublic Healthpublic health insurancepublic hospitalspublic insurancepublic providersquality of carerefugeesRehabilitationscreeningSocial SecuritySocial Security benefitsSocial workerssurgeryunemploymentuse of health care servicesvictimsviolencevisitsworkersWorld Bank10.1596/13292