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.”