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Health Starts at Home: Final Evaluation Report

June 1, 2021

Health Starts at Home was a multi-partner collaboration to improve child and family health for low-income families experiencing housing instability. The Boston Foundation funded four entities, each a partnership of at least one health-care and one housing organization, to design and implement programs to improve service delivery and reduce housing instability for participating families. The evaluators—Health Resources in Action and Urban Institute—tracked changes in these families' housing status, economic well-being, health status and health-care use for the caregivers and enrolled children at baseline, six-month, and 12-month follow-up surveys. The goal of the evaluation was to determine whether improvements in housing stability (achieved through delivery of the four Health Starts at Home program interventions) were associated with improvements in health-related outcomes. Survey data was supplemented by administrative data from the Massachusetts Department of Housing and Community Development (DHCD) on the use of shelters and state rental assistance programs. 

The Emerging Crisis of Aged Homelessness

January 13, 2019

This report summarizes a multi-site study in three localities - Boston, New York City, and Los Angeles County - of the anticipated future of the aged homeless population, its likely impacts on health and shelter systems and resulting costs, and the potential for housing solutions. Specifically, this report summarizes the following analyses:Forecasts of the size of the aged homeless population to 2030Projected costs associated with the use of shelter, health care, and long-term care by this aged homeless populationSegmentation of the forecasted aged population based on the intensity of health and shelter use by various subgroupsPotential service cost reductions associated with housing interventions based on scenarios from prior literatureThe net cost of the proposed housing interventions based on the potential for shelter, health, and nursing home cost offsetsThe report concludes with some considerations regarding how to pay for potential housing solutions, given the complexity of the various funding streams. Absent new housing solutions, substantial public resources will otherwise be spent unnecessarily on excess shelter, health, and long-term care use.Click "Download" to access this resource.

State of the Healthcare Workforce in Massachusetts: Challenges, Opportunities, and Federal Funding

January 5, 2017

This report is the third in a series designed to highlight potential ways for the Commonwealth of Massachusetts to work more effectively with the federal government. The first report in this series, Maximizing Federal Support and Opportunity for the Commonwealth of Massachusetts, examined a number of opportunities by which Massachusetts might work with the federal government to receive additional federal funding, more effectively utilize existing funding, or improve efficiencies in various state-federal partnerships. This report focuses solely on the healthcare workforce, which holds many opportunities in Massachusetts, particularly for low-income workers. The report provides an overview of the state of the healthcare workforce, explains strategies for moving more youth and adults through health career pathways, and explores federal funding sources for workforce training.

Effective Education, Outreach, and Enrollment Approaches for Populations Newly Eligible for Health Coverage

March 13, 2012

Offers strategies, lessons learned, and links to templates, materials, and other resources to help states plan and implement outreach and enrollment efforts, with a focus on those who will become eligible for Medicaid or subsidized coverage in 2014.

Health Reform in Massachusetts as of Fall 2010: Getting Ready for the Affordable Care Act & Addressing Affordability

January 27, 2012

Provides updated survey findings about trends since fall 2006 in the insurance coverage, healthcare access and use, costs and affordability, financial difficulties, and attitudes toward state healthcare reform among non-elderly adults in Massachusetts.

Mitigating Risk in a State Health Insurance Exchange

December 31, 2011

Describes how the Massachusetts HealthConnector designed a risk-mitigation program to stabilize insurance premiums. Offers lessons for federal reform efforts in implementing risk corridors, reinsurance, and risk adjustment.

Determining Health Benefit Designs to Be Offered on a State Health Insurance Exchange

November 30, 2011

As a resource for states in planning and implementing an insurance exchange, provides documents and lessons learned from Massachusetts' development, through a public procurement process, of health insurance products for unsubsidized individual purchasers.

Massachusetts Health Reform: A Five-Year Progress Report

November 18, 2011

Examines the implementation of reform provisions, including subsidized coverage expansion, individual and employer mandates, and insurance exchange; costs and funding; impact on coverage and access to care; and whether healthcare costs can be contained.

Building an Effective Health Insurance Exchange Website

April 5, 2011

Offers lessons and resources from Massachusetts about teams and partnerships, vendors, stakeholder input, system requirements, and ongoing improvement to help states plan, build, and implement Web sites for health insurance exchanges.

Emergency Department Visits in Massachusetts: Who Uses Emergency Care and Why?

September 24, 2009

Analyzes the characteristics of working-age adults using emergency departments for non-urgent care, including health, work, and insurance status; demographics; education; income; type and frequency of visit; and remaining barriers to health care.

Health Reform in Massachusetts: An Update on Insurance Coverage and Support for Reform as of Fall 2008

September 10, 2009

Provides an update on the impact of the state's 2006 health reform on the coverage of 16- to 64-year olds and on support for health reform. Analyzes demographic characteristics, education, work status, and geographic location of the insured and uninsured.

Access to and Affordability of Care in Massachusetts as of Fall 2008: Geographic and Racial/Ethnic Differences

May 28, 2009

Based on a fall 2008 survey, compares access to and affordability of health care, including prescription drugs and dental care, for adults by geography and race/ethnicity. Explores factors behind unmet needs and financial burdens from healthcare costs.