Audit of the Health Policy Commission Overview of the Audited Entity

This section describes the makeup and responsibilities of the Health Policy Commission.

Overview

The Health Policy Commission (HPC) was established under Chapter 6D of the Massachusetts General Laws in 2012 by Section 15 of Chapter 224 of the Acts of 2012. HPC is an independent state agency that is overseen by an 11-member board. This board, by law, consists of experts from various healthcare sectors, including healthcare finance and administration, primary care, consumer advocacy, behavioral health, and the healthcare workforce. According to HPC’s website, its mission is “to advance a more transparent, accountable, and equitable health care system through its independent policy leadership and innovative investment programs,” and its goal is to improve healthcare and make it more affordable for all residents of the Commonwealth. As part of this mission, HPC is responsible for administering all approved grant contracts through the Sustainable Healthcare Innovations Fostering Transformation (SHIFT) Care Program from the Distressed Hospital Trust Fund under Section 2GGGG of Chapter 29 of the General Laws.

SHIFT Care Program

Through the SHIFT Care Program, HPC plans to invest $10 million in approved grant contracts to qualified acute care hospitals² throughout Massachusetts. Funding for the program came from a one-time assessment on acute care hospitals, as required by Chapter 224 of the Acts of 2012. To be eligible for program funding and thus deemed qualified, an acute care hospital must be a nonprofit non-teaching hospital and have relative prices³ below the statewide median relative price. HPC sought applicants that proposed to implement innovative models to address health-related social needs and increase access to behavioral health services, especially those that focus on opioid use disorder (OUD) treatment.

In July 2018, HPC approved grant contracts of approximately $5.6 million of the $10 million to nine community hospitals in installments over the course of 30 months. Projects that the SHIFT Care Program funded included developing a medication-assisted treatment intervention for patients seeking OUD treatment and providing compensation for psychiatrists, nurses, recovery coaches, and data analysts.

2.  An acute care hospital is an inpatient facility that provides surgery services or treatment for short-term conditions.

3.  According to the “Technical Appendix” to the document Provider Price Variation in the Massachusetts Commercial Market by the Center for Health Information and Analysis, “Relative price is a calculated aggregate measure used to evaluate variation in health care provider prices in a given calendar year.”