Putting Public Health into Health Care Reform: Massachusetts' Chronic Disease Integration Pilot Project

Massachusetts is one of four pilot states chosen by CDC to pilot chronic disease program integration. With substantial implementation of Massachusetts' health care reform process underway, 97.3% of residents were insured at the end of 2008. Traditionally, funded chronic disease programs provide access to screening and treatment for uninsured individuals. Our integration goals include: 1. Develop an infrastructure to strengthen the role of public health in health care reform; 2. Develop an internal structure to strengthen the principles and programmatic needs of integration of chronic disease programs; and 3. Develop and implement a comprehensive community approach supporting the prevention and management of chronic diseases. An Integration Leadership Team (ILT) has been formed including representatives from BRFSS, Cancer Control, CVD, Diabetes, Obesity, Tobacco Control, Asthma, Community Health Center programs, Injury Prevention, Oral Health, School Health, and Care Coordination (a merger of Women's Health Network, Men's Health Partnership, and WiseWoman).

With leadership support from the Commissioner of Public Health and the Secretary of Health and Human Services, the ILT is analyzing how its programs interface with each other and how its prior integration efforts can be expanded upon in light of health care reform. Health care reform includes Secretariat-wide efforts relating to quality and cost control initiatives, reimbursement/payment reform, medical home models, creation of a chronic disease blueprint, a diabetes task force and wellness initiative, among others. Our chronic disease integration pilot is developing strategies to maximize the public health role in addressing these issues that extend beyond the strict medical model.