The State Organization Index provides an alphabetical listing of government organizations, including commissions, departments, and bureaus.
Top-requested sites to log in to services provided by the state
Each chapter in the Office of the State Auditor's (OSA) report on Chapter 224 answers a research question presented in Section 251, as noted below. Chapter 4, which was subcontracted to Commonwealth Corporation, addresses several questions.
Research Question for Chapter 1: What are the changes to health care costs, including the extent to which savings have reduced out-of-pocket costs to individuals and families, health insurance premium costs, and health care costs borne by the Commonwealth?
Research Question for Chapter 2: What are the changes to access to health care services and quality of care in different regions of the state and for different populations, particularly for children, the elderly, low-income individuals, individuals with disabilities, and other vulnerable populations?
Research Question for Chapter 3: What are the changes to access and quality of care for specific services, particularly primary care and behavioral health (which includes substance use disorders and mental health services)?
Research Questions for Chapter 4: How did the industrial, occupational, and geographic structure of health care employment in the Commonwealth change?
Research Question for Chapter 5: What are the changes to public health, including, but not limited to, reducing the prevalence of preventable health conditions, improving employee wellness, and reducing racial/ethnic disparities in health outcomes?
To respond to these questions, OSA developed a mixed-methods (quantitative and qualitative), quasi-experimental design for the evaluation. The study explored Chapter 224’s impact on the following:
Because the study touched on numerous matters related to health, health systems, population health, and fiscal policy, OSA sought data from many secondary sources, mainly state and federal agencies. OSA conducted unique analyses of datasets from several of these sources, including Massachusetts’ All-Payer Claims Database (APCD), the Massachusetts Department of Public Health, and the Massachusetts Health Reform Survey.
OSA also extensively utilized peer-reviewed and other sources such as the Substance Abuse and Mental Health Services Administration, the National Survey on Drug Use and Health, Centers for Disease Control and Prevention, Healthcare Effectiveness Information and Data, and reports from foundations, including the Kaiser Family Foundation and the Blue Cross Blue Shield of Massachusetts Foundation.
OSA used of a variety of statistical methods for its quantitative research, as follows:
Qualitative study components included two elements:
1 Reynoso-Vallejo, H., Porche, M., & Stuck-Girard, C. (2015). Chapter 224: stakeholders study. Retrieved April 18, 2017, from mass.gov/auditor/docs/chapter-224/100615-224-stakeholders-survey.pdf
OSA encountered several barriers while attempting to conduct its analyses:
If and when these and other provisions are implemented, it may take several years for their effects to be observed in longitudinal data. Therefore, OSA’s analysis should be viewed as a provisional and not a final verdict on the impact of Chapter 224.
Finally, it is important to note that OSA finalized the content of this report starting in late 2016, so it may not reflect subsequent developments in relevant federal and state policy.