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New from CommonWealth Beacon |
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RETREAT: Local and state officials are looking more directly at the logistics of managed retreat – long a delicate subject for coastal residents. The state is exploring what a voluntary buyout program could look like as the reality of a changing climate hits home. Jordan Wolman has more. |
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GO WEST: Rail projects are inching along in Western Massachusetts, like the long-awaited West-East Rail and increased direct train trips between Boston and Springfield. Hallie Claflin has the details. |
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OPINION: The Bay State should invest in robust summer and after-school learning and enrichment opportunities, write Chris Smith, executive director of Boston After School & Beyond, and former state education secretary Paul Reville, now a professor at the Harvard Graduate School of Education. Most of a child’s life happens outside of the regular hours in school, they write, and an opportunity gap is opening up between those who can and cannot fund private out-of-school programming. |
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| | | By CommonWealth Beacon Staff |
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As she steps down after nearly three decades at the helm of Massachusetts Health Quality Partners, Barbra Rabson is still focused on the primary care crisis. |
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“Primary care has been underfunded and undervalued for years,” she said on The Codcast. “And in this country, what we really have is a sick care system, not a health care system.” |
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Rabson joined John McDonough of the Harvard TH Chan School of Public Health and Paul Hattis of the Lown Institute on the monthly Health or Consequences episode. Data gathered by MHQP over the years paints a clear picture of a primary health system wildly out of balance despite its critical importance, she noted. |
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“All the evidence points to the fact that primary care is the only specialty of the healthcare system that results in longer lives and more equity,” Rabson said. |
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Yet, just 6 cents of every dollar in health care spending in the state went to primary care in 2023, she noted. Fewer than 20 percent of all medical school graduates in Massachusetts end up practicing in primary care, she said, even though primary care makes up about 50 percent of all ambulatory visits in this country. |
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The primary care workforce is aging, is paid less than other specialists, and the lack of capacity is creating barriers for access. |
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Rabson is a member of the 25-member task force on primary care access established by Gov. Maura Healey last January, which is due to release additional recommendations in May on some of the “trickier” items. |
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The data dashboard launched in partnership with the independent state agency Center for Health Information and Analysis showed a “downward spiral” as the Covid-19 pandemic began raging, Rabson said. Digging into the crisis further revealed persistent problems attracting and keeping primary care physicians, who have been losing autonomy as large health care systems snap up smaller practices. |
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Pay discrepancy isn’t the only concern for Rabson – there is also a data discrepancy. Only 0.3 percent of national federal research dollars go into primary care, she said. |
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On a national level, she said, “we're just not investing in the research we need to know, okay, how do we do a better job of this, how do we attract people, and how do we be more efficient?” |
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On the episode, Rabson reflects on MHQP’s mission and upcoming 30th anniversary gala (1:30), how Massachusetts stacks up on measurement and transparency in health data (15:30), and the supply chain problems for primary care physicians (17:30). |
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More from CommonWealth Beacon |
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ELECTRIC BUSES: A quiet debate about how and whether the T can or even should meet an ambitious electric bus mandate is now spilling into the open, Chris Lisinski reports. |
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PRIMARY CARE: The primary care crisis grows more complicated in rural areas like the Berkshires, as patients and health systems describe long waits for preventative care and physicians are swamped under the weight of administrative burden. (The Berkshire Eagle – paywall) |
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GATEWAY CITIES: GBH looks at the impact of the Transformative Development Initiative, a state program created in 2014 to help revitalize Gateway Cities by stabilizing and boosting local businesses. (GBH News) |
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IMMIGRATION: Lawmakers are grappling with how to fund legal assistance for immigrants in this year’s budget cycle. (WBUR) |
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ELECTIONS: A New Bedford city councilor is running for lieutenant governor alongside Republican gubernatorial candidate Brian Shortsleeve. (The New Bedford Light) |
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COURTS: The US Supreme Court will hear arguments on Wednesday on President Donald Trump’s attempt to dramatically reshape “birthright citizenship” as it’s been understood for more than 150 years. A narrowing of this constitutional right could have profound effects on the educational landscape. (NPR) |
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