Massachusetts Senate Releases Healthcare Report and Draft Legislation to Contain Costs, Protect Consumers

The Massachusetts Senate released a report “Working Together to Improve Our Health: Right Care, Right Place, Fair Price, Recommendations from the Senate Working Group on Health Care Cost Containment and Reform,” that focuses on both short and long terms goals on how to strengthen our healthcare system to lower costs, improve outcomes, and enhance access. The report and accompanying draft legislation is the result of a collaborative effort by a group of Senators to address the healthcare system by analyzing the best practices in other states and engaging stakeholders in a series of meetings over the last year.

Healthcare costs are continuing to strain the budget of working families, businesses, and working families. The Senate has continued to push for reforms to the current system through diligent research, stakeholder engagement, and legislation. The working group of Senators, with the logistical support of the Milbank Memorial Fund spent the last year meeting with officials from seven states, healthcare experts, and stakeholders to examine best practices while lowering costs and improving outcomes.

“Massachusetts should continue to lead on healthcare, and having a robust economy depends upon on lowering costs for everyone without compromising quality or access. The recommendations in this report will help working families, businesses, and our state budget,” said Senate President Stan Rosenberg. “I’m very proud of the work the Senate did to craft a comprehensive report and draft legislation that touches so many aspects of our healthcare system and meets the needs of all engaged stakeholders.”

“This important legislation takes meaningful steps to both improve healthcare quality and outcomes, as well as contain costs,” said Senator Jason Lewis, who served on the Senate Working Group on Health Care Cost Containment and Reform, as Senate Chair of the Joint Committee on Public Health. “More deeply, this legislation furthers efforts to address the social determinants of health that are responsible for many health inequities in our system; and, innovative steps are taken to make prevention a more central component of our healthcare system, which will improve our quality-of-life and save money.”

The goals outlined in the report vary from more effective care delivery such as telemedicine and mobile integrated health to reducing emergency room visits to expanding provider versatility while also addressing price variation between larger hospitals and their smaller community hospital counterparts. The report outlines a series of recommendations that will achieve these goals and lower costs as a result of implementation.

The bill takes concrete steps to expand provider versatility to increase access to lower cost providers. It expands provider treatment authority for nurse practitioners, certified registered nurse anesthetists, psychiatric clinical nurse specialists, optometrists, and podiatrists; additionally, it establishes a mid-level dental therapist (DT) certification.

A DT would be able to perform procedures including basic tooth extractions, fillings, and taking x-rays, freeing up dentists to focus on complicated cases. Currently, in Massachusetts over a half-million residents live in dentist shortage areas as defined by the US Department of Health and Human Services, and in 2014 only 35 percent of dentists treated MassHealth patients. As a result, 44 percent of children on MassHealth (over 284,000) did not see a dentist in 2015. This bill is uniquely designed to target those living in dentist shortage areas by allowing DTs additional freedoms to operate under non-profits and in a licensed mobile dentistry program. By reaching out to underserved populations, the culture around oral healthcare can begin to change.

The bill also reauthorizes and updates the successful Prevention and Wellness Trust Fund (PWTF), and provides opportunities for new sources of funding, a major priority of Senator Lewis’. The PWTF funds community partnerships made up of municipal governments, healthcare providers, and local health and human service organizations, all working closely together to achieve a community-wide focus on prevention and wellness. Early results from an assessment conducted by Harvard Catalyst indicate that “to date, PWTF appears to be a very sound investment from the point of view of improving outcomes and controlling costs.”

The report aims to reduce hospital re-admissions and emergency department use through mobile integrated health and telemedicine as well as expanding access to behavioral health. Massachusetts Health Policy Commission has estimated that 42 percent of all Emergency department visits are avoidable.

Post-acute care in an institutional setting and long term care and supports (LTSS) cost the state an estimated $4.7 billion in 2015, a major cost driver for MassHealth. The report recommends increased transition planning for patients into community settings and strengthening coordination between providers.

Pharmaceutical costs have been a driver of increased healthcare costs for a number of years. The Center for Health Information and Analysis (CHIA) reported a 6.4 percent growth in pharmaceutical spending in 2016. Drug costs are making families choose between filling prescriptions and paying for other essentials like housing and food. The report recommends greater oversight and transparency in drug costs and encourages Massachusetts to enter into bulk purchasing arrangements, including a multistate drug purchasing consortium like other states, to lower costs and protect consumers.

The scope of the report encompasses the whole system from Medicaid to the commercial market, and makes additional recommendations on how to lower costs, address price variation, increase price transparency for consumers, leverage better federal funding opportunities, and many other recommendations. A copy of the report and draft legislation can be found online at https://malegislature.gov/Committees/Detail/S61/Documents.

Column: We Need To Do More to Stop Wage Theft

Earlier this year, at the start of the new legislative session, we were pleased to be appointed by the Senate President and House Speaker, respectively, to co-Chair the Joint Committee on Labor and Workforce Development. Together, we have since immersed ourselves in a wide range of labor and employment issues in the Commonwealth. We have held committee hearings on proposed legislation, met with many different stakeholders to hear their concerns and feedback, and conducted research on policies and best practices around the country.

One particular issue that may surprise many people is the serious problem of wage theft. Wage theft is a collective term for any denial of wages or benefits that are rightfully owed to an employee. The most common wage theft violations in Massachusetts are non-payment of wages, failure to keep true and accurate records, failure to pay the proper overtime rate, child labor violations, failure to pay minimum wage or tips, and failure to pay prevailing wage. Other violations include failure to submit accurate payroll records, earned sick time violations, and improper classification of employees as independent contractors.

Just how pervasive is wage theft? It is estimated that nearly $700 million is not paid to about 350,000 mostly low-wage workers each year in Massachusetts. In addition to the harm this inflicts on struggling working families, it also cheats the state out of greater economic activity, jobs, and tax revenue.

The Attorney General’s Office (AGO) is the state’s primary enforcer of laws relating to wages. Enforcement is carried out by attorneys and investigators in the AGO’s Fair Labor Division (FLD). In Fiscal Year 2017, the FLD received 16,684 calls and 5,604 complaints, and opened 607 cases related to wage theft. The FLD ordered employers to pay more than $6 million in restitution and more than $2.6 million in penalties. This is more than double the restitution ($2.6 million) and about triple the penalties ($900,000) from Fiscal Year 2016. The FLD also cited or settled 27 earned sick time cases, totaling $160,000 in restitution and penalties. And, the FLD issued 47 citations to 46 employers and assessed more than $270,000 in penalties for child labor law violations.

Wage theft investigations spanned more than twenty different industries, with the restaurant and construction industries having the highest percentage of violations cited. Perpetrators of wage theft and worker exploitation typically target vulnerable populations like low-wage workers and immigrant workers.

Vigorous enforcement of our labor laws is critical to ensure that workers are paid what they are owed, the playing field is level for the majority of businesses that follow the law, and to protect the Commonwealth from lost revenue in the form of taxes and unemployment insurance contributions.

To be proactive, the AGO has also worked with community partners to put on Wage Theft Clinics for workers. More than 230 workers have received free consultations at these clinics so far, and more than $65,000 in stolen wages has been recovered. Volunteer lawyers, law students, interpreters, and workers’ rights advocates are on hand to educate workers about their rights, draft demand letters, or prepare small claims court complaints. For questions about upcoming Wage Theft Clinics or other inquiries about the AGO’s enforcement of laws relating to wages, contact the FLD at (617) 727-3465.

In the legislature, the Joint Committee on Labor and Workforce Development, is considering several bills to help combat wage theft, including An Act to Prevent Wage Theft and Promote Employer Accountability, sponsored by Senator Sal DiDomenico and Representative Aaron Michlewitz. This important legislation would further strengthen the enforcement powers of the AGO, and would hold lead contractors accountable for wage theft violations of their subcontractors as long as there is a significant connection to their business activities.

Through education, enforcement, and legislation, we must do more to stop wage theft in Massachusetts.

Senator Jason Lewis
Senate co-Chair, Joint Committee on Labor & Workforce Development

Representative Paul Brodeur
House co-Chair, Joint Committee on Labor & Workforce Development

Senate Releases MassMoves Report to Create a 21st Century Transportation Vision for Massachusetts

The Massachusetts State Senate released its MassMoves report highlighting residents’ priorities for a forward-thinking 21st century vision for the Commonwealth’s transportation system. The Senate launched the MassMoves initiative as a part of the Commonwealth Conversations Tour in order to collect feedback directly from residents to help envision a better transportation system across Massachusetts.

The MassMoves executive summary and full report, entitled MassMoves: A Vision for the Commonwealth’s 21st-Century Transportation System, can be accessed online at https://MALegislature.gov/CC/. This work was supported by the Barr Foundation.

“A reliable, accessible, and affordable public transportation system is vital for robust economic growth and a sustainable quality-of-life across our region,” said Senator Jason Lewis. “Those who rely on public transit span demographics and geography, from a commuting workforce, to students and senior citizens, to families traveling to recreation spots across the region and state. Feedback directly from residents locally and statewide was integral to guiding the Senate’s planning on transportation to ensure that the Commonwealth meets its residents’ public transit needs in the years ahead.”

Over 700 citizens were engaged during nine transportation-focused workshops held during the Commonwealth Conversations Tour across Massachusetts. Participants agreed that transportation needs to run efficiently, especially rail and bus. Participants expressed favor for additional investment in transportation through broad-based general taxes over targeted user fees. All nine transportation workshops support allowing local government to raise money for local transportation projects. The report also highlights transportation priorities in nine regions of Massachusetts.

The Commonwealth Conversations Tour, not to be confused with Senator Jason Lewis’ local Community Conversations series, is a statewide listening tour spanning nine regions across the state, giving the Senate the opportunity to meet with local residents, businesses, and interest groups in every corner of Massachusetts to hear their concerns directly on issues of importance to every resident.

Senator Jason Lewis Appointed to Task Force on Strengthening Local Retail

Massachusetts Senate President Stan Rosenberg and Senate Minority Leader Bruce Tarr announced the appointments of Senators and retailers to the Senate Task Force on Strengthening Massachusetts Local Retail. Among the appointments to the task force is Senator Jason Lewis, the Senate Chair of the Joint Committee on Labor and Workforce Development. The task force was established to work with the Senate to identify ways to help local retailers become more competitive.

The Task Force will address a number of key factors, including: challenges faced by local retailers in competing against online sellers; closures of local retail establishments and the impact that has on local economies and property tax bases; initiatives by local retailers to increase their market share; and, how state and local governments can encourage purchasing from local retailers.

“Our local small businesses and Main Street retailers are vital to local economic development and the well-being of our communities,” said Senator Jason Lewis. “Policymakers must work closely with them to help address the challenges they are facing in an ever-changing economy. This task force will provide an important avenue for further collaboration between the private and public sectors. I am eager to hear feedback from retailers in our communities and to work with my colleagues on the task force to achieve solutions that will strengthen prosperity on our Main Streets.”

In addition to Senator Lewis, Senate President Rosenberg appointed Senator Michael Rodrigues, who will serve as Chair, as well as Senators Mike Barrett, Julian Cyr, and Kathleen O’Connor-Ives. Senate Minority Leader Tarr appointed Senators Vinny DeMacedo and Don Humason.

The retailers appointed by Senate President Rosenberg are Judy Herrell, owner of Herrell’s Ice Cream in Northampton, Peter Kavanaugh of La-Z-Boy Furniture Galleries in Dartmouth, Barry S. Rotman, Board Chair of Rotman’s Furniture in Worcester, and Malcolm Sherman, a retail consultant with expertise in turning around struggling businesses. The retailers appointed by Senate Minority Leader Tarr are Christopher Carlozzi, State Director of the National Federation of Independent Business, John Cahill of Landry & Arcani Rugs in Salem, and Christopher Connolly, President of the Massachusetts State Automobile Dealers Association.

The remaining appointees are Jim Carvalho, Political Director of the United Food and Commercial Workers Local 1445, Harris Gruman, Executive Director of the SEIU Massachusetts State Council, and Jon Hurst, President of the Retailers Association of Massachusetts. Outside experts with expertise in business and economics may also be consulted to assist the Task Force in facilitating its work.

The Task Force will report back to the Senate President and Senate Minority Leader by June 1, 2018.

Senator Jason Lewis Joins Fair Skies Caucus to Address Airplane Noise and Pollution

Senator Jason Lewis has joined the recently created Fair Skies Caucus of the Massachusetts Legislature. The objective of the Fair Skies Caucus is to bring together Senators and Representatives whose districts are affected by airplane noise and pollution to find meaningful solutions to the problem. The Caucus will collaborate with members of the Massport Community Advisory Committee in order to optimize advocacy for those communities that are impacted by overflights from Logan Airport, Worcester Airport, and Hanscom Field.

The caucus, formed just last month, aims to encourage bipartisan and bicameral collaboration on relevant legislation and budget matters, and will unite the advocacy efforts of its individual members in order to more effectively collaborate with Massport and other agencies.

“Heightened concerns regarding airplane noise and frequency were shared over the summer by constituents as Logan Airport undertook runway repairs that led to alterations in flight paths, which led to increased noise impacting our communities,” noted Senator Jason Lewis. “Unique situations like that, as well as the issue of airplane noise in general, affect people’s quality of life in our region and require greater communication between Massport and the public. I expect that the Fair Skies Caucus will serve as a mechanism to enhance that communication, to strengthen advocacy on behalf of our region’s residents, and to achieve solutions to these concerns.”

In addition to creating a forum for legislators to work jointly on issues pertaining to airplane noise, the caucus will allow for increased collaboration with members of the Massport Community Advisory Committee (Massport CAC). The Massport CAC, comprised of representatives from 35 communities, serves as the voice of communities affected by Massport operations. People can learn more about the operations of the Massport CAC, as well as issues of airplane noise and related topics, at http://MassportCAC.org/.

By optimizing advocacy efforts through the Fair Skies Caucus, legislators will work collaboratively to find meaningful solutions to an issue affecting communities across the Commonwealth.

Senator Jason Lewis to Host Community Conversation in Stoneham on Arts and the Local Economy

Continuing his “Community Conversations” issue discussions, Senator Jason Lewis is excited to announce an upcoming conversation he will hold on the impact of the arts and cultural sector on our local economy. Held in every community of the district, “Community Conversations” are issue discussions delving into a different topic at each forum, with ample opportunity for residents to share feedback and have their questions answered by experts on the given topic.

This upcoming event – Community Conversations: Investing in Arts and Culture to Strengthen Our Local Economies – will take place on Tuesday, September 26, at 6:30pm. The event will occur at the Stoneham Theatre, 395 Main Street, Stoneham, and is free and open to the public. Attendees will hear from: Anita Walker, Executive Director of the Massachusetts Cultural Council; Christopher Carino, Chairman of the Town of Wakefield’s Albion Cultural Exchange Committee; and, Amanda Chisholm, Chief Economic Development Planner for the Metropolitan Area Planning Council (MAPC).

This forum will offer the chance to hear directly from numerous issue experts regarding the benefits to our local economies provided by the arts and cultural sector, and how our communities can best engage the arts and cultural sector as part of strategic economic development. There will be ample opportunity for Q&A from attendees. The forum is co-sponsored by the municipal Cultural Councils of Malden, Melrose, Reading, Stoneham, Wakefield, and Winchester, as well as State Representative Michael Day and the Stoneham Chamber of Commerce.

“Local arts provide our communities not only with entertainment and education, but also with substantial economic stimulus,” noted Senator Lewis. “I look forward to discussing with this distinguished panel how we can invest in communities that are simultaneously culturally vibrant and economically thriving. I am also eager to hear feedback on this from local residents, as the conversations I have directly with constituents across the district are the best source of information and guidance to help me do my job in the legislature.”

“Community Conversations” forums have been held in all six communities of the 5th Middlesex district on topics including: public education; public transportation; small business and entrepreneurship; challenges facing senior citizens and caregivers; veterans’ issues; housing; energy policy and environmental priorities; and, efforts to combat substance abuse and opioid addiction in our region.

Column: The Benefits and Challenges of Autonomous Vehicles

More than 150 years ago, education reformer Horace Mann recognized that the economic success of Massachusetts depended on human brainpower and innovation. He famously said, “Having no other mines to work, Massachusetts has mined into the human intellect; and, from its limitless resources, she has won more sustaining and enduring prosperity and happiness than if she had been founded on a stratification of silver and gold, reaching deeper down than geology has yet penetrated.”

Today, the Commonwealth continues to be a national and global leader in technology and our economic growth and prosperity depends even more on our creativity and ability to foster innovation.

One exciting area of new technology where I believe Massachusetts should seek to lead the way is autonomous, or self-driving, vehicles. An autonomous vehicle (AV) is capable of navigating without human input by sensing its environment and proceeding accordingly. Seemingly the stuff of science fiction not too long ago, AV technology has made such significant advances that experts estimate they could be commercially available within the next five years.

Autonomous vehicles offer the potential for significant benefits to our society and economy. Improved safety and reduced accidents are certainly at the top of the list. AVs hold the promise of greater transportation accessibility and social mobility for elderly, disabled, and low-income people. They could also enable a transformation in urban design, with much more efficient use of roadways and less need for parking spaces.

At the same time, this new technology brings potential risks and challenges that need to be anticipated and proactively addressed. Current public perception is that AVs are less safe than human drivers and, understandably, it will take time before people are willing to trust their lives to self-driving cars. Experts predict that AV technology, if not effectively managed, could actually increase vehicle miles traveled (VMT) by 20-40%, increasing congestion on roadways and increasing pollution and carbon emissions. There is also the prospect of “zombie” cars (vehicles with no passengers inside) endlessly circulating to avoid paying for parking or to serve as mobile billboards. Additionally, AVs could impact revenue streams upon which our cities, towns, and state depend, such as parking tickets, speeding tickets, and gas taxes.

I believe Massachusetts is well positioned to help ensure that we realize the benefits of AVs while effectively managing the risks. In doing so, we could become global leaders in this transformational technology. Working together with the Conservation Law Foundation, I’m pleased to have sponsored legislation in the Senate, An Act to Promote the Safe Integration of Autonomous Vehicles into the Transportation System of the Commonwealth. This bill incorporates the best policy ideas and practices from the federal government and other states to encourage a transition to a shared, clean-energy fleet of AVs, resulting in less congestion, cleaner air, lower greenhouse gas emissions, and greater mobility options for all Massachusetts residents.

The legislation creates a flexible regulatory framework to allow and encourage AVs on our roads, without limiting that right only to certain auto manufacturers. Critical safety measures are included, like rigorous testing, regular software updates, and failure alert systems. The bill also seeks to strongly encourage AVs to be zero-emission (electric) vehicles, and to promote shared use. Finally, the bill establishes a road usage charge (VMT) to replace lost gas tax revenue, with a base rate per mile and various discounts for factors such as multiple passengers, off-peak hours, certain geographic areas, lower income riders, lighter vehicles, etc.

As AV technology advances, we must also consider other public policy ramifications, such as lost jobs for taxi/TNC and truck drivers and the impact on urban redesign of our cities and towns. These are big challenges that we must start thinking about and planning for now.

Column: Moving Forward Safely with Marijuana Legalization

Last week Governor Baker signed into law legislation that I believe will make Massachusetts a national model when it comes to safely regulating the legal sale and consumption of marijuana. This legislation fully respects the will and intent of the voters — who voted last November to legalize the recreational use of marijuana — while taking strong steps to ensure that we don’t turn a criminal justice problem into a public health problem.

For me, the signing of this bill was also the culmination of a two and a half year journey into the minutiae of marijuana policy. To be honest, marijuana was not high on my list of priority issues when Senate President Stan Rosenberg appointed me to Chair a Special Senate Committee on Marijuana in early 2015. President Rosenberg had the foresight to anticipate that the question of marijuana legalization might be on the ballot in 2016, and he knew this is a complex issue that would require the Senate to be well prepared.

The Special Committee conducted extensive research, interviewed dozens of marijuana policy experts, and traveled to Colorado to learn from that state’s experience as the first to legalize recreational marijuana. We found that marijuana legalization involves dozens of policy questions, from how to regulate what is likely to be a new billion dollar industry to what kinds of products should be allowed for sale and how they can be marketed to challenges involving conflicting state and federal laws, and much more. We published our findings and recommendations in a detailed report in March 2016.

I concluded that I could support marijuana legalization in Massachusetts, but only if public health and safety were put ahead of industry profits. I made the decision to oppose Question 4 because I believed that the authors of this ballot question (marijuana activists and industry players) did not adequately address public health and safety concerns, particularly what I feared would be industry efforts to target youth as we have seen with the tobacco and alcohol industries.

After the passage of Question 4, the legislature created a new Committee on Marijuana Policy to gather input from all stakeholders and work as quickly as possible to fix the serious flaws in the ballot question. That launched a six month process that entailed numerous public hearings around the state and intensive discussions with all stakeholders — including public health experts, law enforcement, state and municipal officials, businesses, medical marijuana dispensaries, patients, as well as the activists who successfully campaigned for the ballot question — to understand their concerns and how best to address them.

The legislation that resulted from this process is a very strong bill that addressed many of these concerns, including my own. I believe this legislation fully respects the will of the voters; will replace the current black market with a safe, tightly regulated, legal market; ensures very strong public health and safety protections to reduce underage use and excessive consumption; and promotes a responsible industry that is diverse, encourages local players, and helps rather than hurts communities that have historically been disproportionately impacted by the war on drugs.

I believe many of the specific provisions in this legislation will make Massachusetts a national model for how to safely and effectively legalize marijuana. These include: a strong, independent regulatory body that has the necessary expertise and will not be subject to undue industry or political influence; a careful merging of the oversight of medical marijuana with recreational marijuana along with stronger protections for patients; the strongest product, packaging, labeling, and marketing requirements and restrictions in the nation; a comprehensive research and data collection program to guide future public policy; public health and safety campaigns; various social justice provisions to address past inequities and harms of the war on drugs; a special commission on ways to prevent and address drugged driving; strong standards for energy and water usage and other environmental concerns in marijuana cultivation; and a responsible tax rate that appropriately balances the need for revenue to cover regulatory and social costs while driving out the black market.

We are on track to proceed with marijuana legalization, with legal sales expected to begin by the middle of next year. I have no doubt we still have much to learn and there will be bumps along the road, but I’m optimistic that Massachusetts can do this right.

Senate Passes Healthy Youth Act with Senator Jason Lewis’ Support

With the support of Senator Jason Lewis, Senate Chair of the Committee on Public Health, the Massachusetts Senate passed S. 2113, An Act Relative to Healthy Youth, which will ensure that school districts in the Commonwealth that elect to provide their students with sex education provide age-appropriate and medically accurate information that includes coverage of both abstinence and contraception.

Currently, when Massachusetts public schools provide their students with health education that covers sexual activity, there is no guarantee that the information provided is age-appropriate or medically accurate. This legislation changes this by requiring school districts that choose to offer sexuality education follow certain guidelines to ensure that students are provided with age-appropriate and medically accurate information.

“Providing comprehensive, age-appropriate, and medically accurate information to our youth is the best way to prepare them to make safe and healthy choices,” said Senator Jason Lewis. “I’m pleased that the Senate was able to advance this legislation that will strengthen education and reduce rates of teen pregnancy and transmission of sexually transmitted infections, while keeping parents informed as to students’ curricula.”

Under the bill, sexual health education must include but not be limited to: the benefits of abstinence, delaying sexual activity, and the importance of effectively using contraceptives; ways to effectively discuss safe sexual activity; relationship and communication skills to form healthy, respectful relationships free of violence, coercion, and intimidation, and to make healthy decisions about relationships and sexuality; physical, social, and emotional changes of human development; human anatomy, reproduction, and sexual development; and, age-appropriate information about gender identity and sexual orientation for all students.

Senator Lewis successfully advocated for the inclusion of an amendment to the bill to require the Board of Elementary and Secondary Education to update the comprehensive health curriculum framework, which hasn’t been updated since 1999.

Sex education programs have repeatedly been shown to work best when they emphasize the value of abstinence, while also teaching students about the importance of protecting themselves from unintended consequences. This type of comprehensive curriculum is proven to be more effective at delaying sexual activity among young people, increasing the rate in which young people use contraception, while also lowering rates of sexually transmitted infections (STIs) and teen pregnancy.

The bill does not require schools to provide sexuality information. Local school boards and schools still make all decisions about whether to offer sex education. This legislation also maintains existing state law that allows parents to remove their children from sex education programs and gives school districts clearer guidance on how to notify parents about these programs.

School districts that provide a sexuality curriculum must adopt a written policy to give parents and legal guardians notification and inform them of the right to withdraw their child from all or part of the instruction. Notification to parents and guardians must be in English, as well as any other commonly spoken languages by parents. Districts must also have a process for parents to review the program instruction materials prior to the start of the course, if the parents request it.

This bill now moves to the Massachusetts House of Representatives for consideration.

Column: Telemedicine Improves Healthcare Access and Reduces Costs

New technology like telemedicine holds great promise for improving access to care for patients, improving health outcomes for the treatment of chronic illnesses, and reducing healthcare costs. We should take steps to enable the expanded use of telemedicine in Massachusetts.

Telemedicine is the remote diagnosis and treatment of patients through online communications, including video and specialized technologies. It complements in-person delivery of healthcare services. Telemedicine can improve care by giving all patients, regardless of where they live or mobility limitations, convenient access to all levels of healthcare services, including primary care providers, specialists, and behavioral health clinicians. By making it easier and faster for a patient to be evaluated by a healthcare provider, telemedicine has been shown to improve the health of patients suffering from chronic diseases such as asthma, congestive heart failure, chronic obstructive pulmonary disease, diabetes, and hypertension. Telemedicine has also been shown to help reduce hospital readmissions, decrease lengths of stay, and cut down on emergency room visits.

A 2015 Harvard Medical School study published in the American Journal of Managed Care estimated that a typical in-person visit to a doctor consumes about 2 hours of a patient’s time, with only 20 minutes actually spent face-to-face with the physician. Many people also have a difficult time accessing some healthcare services due to mobility or transportation limitations, long distances necessary to travel to a specialist’s office, time constraints, or challenges scheduling an appointment due to the busy nature of many providers. Expanding access to telemedicine will assist patients in receiving more timely and convenient treatment regardless of economic means, physical ability, transportation options, or geographic location.

By improving access to care and increasing the efficiency of care delivery, telemedicine can help control healthcare costs and make care more affordable for families, seniors, businesses, and our state and local governments.

For example, in 2012, the Mass. General Hospital/Brigham & Women’s Hospital Tele-Stroke network provided 24/7 acute stroke neurology coverage to emergency departments across 11 counties in Massachusetts, providing care to more than 700 patients. This resulted in approximately 400 avoided transfers to academic medical centers, totaling more than $2 million in savings to the Massachusetts healthcare system.

To enable the increased use of telemedicine in Massachusetts, I have filed An Act Advancing and Expanding Access to Telemedicine Services. This legislation will ensure parity in insurance coverage for telemedicine services at equivalent payment rates as in-person treatment; streamline the credentialing process for Massachusetts licensed clinicians using telemedicine services within the state; and ensure a uniform and consistent approach when defining telemedicine services.

Massachusetts is currently one of only two states that do not provide expanded coverage for telemedicine through Medicaid and commercial health insurance plans. For example, MassHealth (the state’s Medicaid program) only provides coverage for remote tele-monitoring for home health services.

This legislation is supported by a broad coalition of healthcare providers, consumer groups, and business organizations, including the Massachusetts Health and Hospital Association, Atrius Health, AARP Massachusetts, Health Care For All, the American Heart Association/Stroke Association, Planned Parenthood of Massachusetts, the Massachusetts Chapter of the National Association of Social Workers, and the Massachusetts Association of Behavioral Health Systems.

If Massachusetts is to remain a leader in providing high quality healthcare, improving health outcomes, and reining in high healthcare costs, we should embrace the full potential of telemedicine.