reform legislation


Mass. Minors Buying E-Cigs? Maybe Not For Long.

(Wikimedia Commons)

(Wikimedia Commons)

I was shocked to find out that minors can buy electronic cigarettes in the state of Massachusetts.

But not for much longer, if a new piece of legislation has its way.

The bill, released today by state Rep. Jeffrey Sánchez, co-chair of the Joint Committee on Public Health, seeks to fix the loophole that allows the free sale of electronic cigarettes and other nicotine delivery products. Though cigarettes are tightly regulated under the Tobacco Control Act of 2009, the FDA and other federal organizations do not currently regulate the sale of alternative nicotine delivery products.

The current state of disarray is caused in part by the development of new tobacco products since the passage of the 2009 act. According to a press release and accompanying fact sheet, Sanchez’s bill would define existing and future tobacco and nicotine delivery products, such as e-cigarettes, ensuring that future products would also be subject to regulation. It would restrict sales of any of these products to minors under the age of 18. And it would prevent the use of electronic cigarettes everywhere that smoking is banned, including in the workplace.

Currently, 12 other states regulate the sale of e-cigarettes: Continue reading

Mass. Blue Cross Reports High Marks For Global Payment Plan

Dr. Bob Weinstein, chief of family practice at Signature Healthcare

WBUR’s Martha Bebinger reports this morning on promising results from the first year of a Blue Cross Blue Shield global payments plan. Check out her full report, including audio, here.

As the state ponders a move to global payments to improve care and control health care spending, there is early evidence the strategy works.

Eight hospitals and physician groups that have been under this new payment model through Blue Cross and Blue Shield for at least a year are releasing the results. The groups all came in under budget and scores show they improved care. The verdict is out on whether patients like the change.

These hospitals and doctors say the move to global payments is a big deal. Doctors and hospitals receive a yearly budget for all their Blue Cross patients instead of getting paid for every office visit, test and procedure. The goal is save money while providing better care.

So let’s look at how these providers did in their fist year in three areas: cost, the quality of care and patient satisfaction.

Quality goes up

On quality, Blue Cross says at least twice as many patients under a global payment got cancer screenings, regular check-ups and kept their diabetes or heart disease under control as did patients in traditional plans.

Doctors at Tufts Medical Center boosted their patient quality scores, in part, by creating a registry of patients with a chronic disease and assigning nurses to track who needed a test or an appointment.

Jeffrey Lasker, CEO at the Tufts physician network, says the registry “helped us identify the patients who are in need of screenings or other follow-up measures so that’s been very highly effective.” Two years ago, Tufts fought pressure from Blue Cross to sign this global payment contract. But Lasker says once physicians started working under it things went well.

Costs go down

On costs, Blue Cross has pledged that over five years, the move to global payments will cut rising health care costs in half. Instead of going up at roughly 10-12% a year, the increase would be 5-6%.

So are these providers on track? Continue reading