Progress Report of the
Medical Task Force Working Group

March 2006

Introduction

The U.S. health care system is dynamic, and is characterized by scientific advances and corresponding increases in cost. Within this context, MIT must continue to adapt to change. The Institute must find ways to improve the quality—while examining all aspects of the costs—of the medical services and health insurance coverage it provides to its students, employees, retirees, and post-docs.

In November 2005, a Task Force chaired by Professor Paul L. Joskow issued a report with 41 recommendations (PDF) aimed at: improving the quality of, and access to, health care by the MIT Medical Department; improving satisfaction with health insurance options; and reducing the cost of providing health care and health insurance to the MIT community.

The current Medical Task Force Working Group, led by Executive Vice President Sherwin Greenblatt, is charged with assessing the recommendations and implementing strategies. The Working Group includes representatives from the Medical Department, Human Resources, the Office of Finance, and senior administration. Feedback from the MIT community via surveys, focus groups, and personal communications has provided direct input to the implementation of these recommendations.

This progress report provides a summary of the activities and actions undertaken through March 2006, as well as a link to the complete table of details (PDF).

Scorecard

All of the 41 recommendations have been actively considered, and many have resulted in direct implementation. Of these, some are complete and some are ongoing in nature. New practices have been introduced, and efforts at continual improvement are in place. Some recommendations are works-in-progress.

All recommendations are available for review in the table of details (PDF), which the Working Group uses to track progress.

Summary of recommendations

The 41 recommendations fall into two broad categories: those pertaining to the MIT Medical Department, and those pertaining to the health insurance programs made available to the MIT community. The underlying imperative is to reduce the cost of providing health care and health insurance while enhancing the quality of health care at MIT.

Recommendations targeted at the MIT Medical Department

There have been improvements in both access to and quality of care at MIT Medical, as well as advances in budgeting and the financial management of the department.

Many of the changes and new practices relative to access to care, waiting times, privacy issues, health education, and communication resulted from suggestions in patient surveys.

Specifically, MIT Medical has thus far:

  • Hired three triage nurses, increasing their number to five. Triage nurses assign incoming patients to appropriate care providers in MIT Medical more quickly. The increased staffing will help walk-in patients as well as those who seek care or advice on the phone.
  • Increased the number of clinicians in dermatology, internal medicine, and ob/gyn, facilitating access to specialists and establishing preferred provider relationships to better meet urgent needs.
  • Increased patient privacy by renovating space in two clinical areas.
  • Improved how it interfaces with students. Examples: correspondence with parents of first-year students, new wellness programs, IAP sessions, and support for the student-staffed Ambulance Service and MedLinks Program in residences.
  • Collaborated with service providers both outside and inside MIT—e.g., DSL and DUE—to produce and distribute better-designed and integrated communications about MIT Medical services.
  • Created and distributed educational and promotional materials through several channels to other audiences. Started analyzing statistical data on a more regular basis, to better measure progress.
  • Created plans to conduct annual surveys that will monitor service levels.
  • Developed a model of financial management and analysis that facilitates allocating costs and revenues to specific lines of business. This is seen as a tool for achieving fiscal balance in the area of providing medical services to retirees.

Among the recommendations still under consideration for the Medical Department are:

  • Expanding wellness and other education and support programs;
  • harnessing information technology to facilitate the exchange of medical information;
  • creating a digital medical records system;
  • partnering with one or two of Boston's major hospital groups;
  • bringing retiree medical care into fiscal balance, and developing a long-term strategy to keep it there; and
  • evaluating mental health care services in light of the increase in students being served, following the recommendations of the Mental Health Task Force.

Comprehensive evaluations in the areas of mental health service, the role of the primary care physician in student health care, and partnerships with the Boston medical community are in progress and will be completed by the end of 2006. Clients will be surveyed periodically on the quality of care services provided, starting in fall 2006.

The full list of recommendations and actions as of March 2006 are available in the table of details (PDF).

Recommendations targeted at health insurance programs and general coverage

Movement on recommendations targeted at health care plans and other Institute-wide considerations has been delayed pending the arrival of a new benefits director. With the appointment of Patricia Fay, specific actions in these areas are now a high priority.

The work-in-progress recommendations include:

  • Reevaluating the current formula for cost-sharing between MIT and employees, from a total compensation and benefit package perspective;
  • improving MIT's ability to effectively implement its self-insurance strategy;
  • considering whether and how the MIT health plans, the BC/BS plans, and the Tufts plan can be redesigned to make more effective use of creative co-payment structures;
  • reevaluating whether to continue to offer the Tufts Health Plan as an MIT health insurance option;
  • evaluating whether MIT should offer a catastrophic health care option with a high deductible and co-payment provisions, perhaps in conjunction with a Health Savings Account (HSA);
  • reevaluating health insurance options for faculty members on sabbatical leaves; and
  • improving employee awareness of MIT's long-term care insurance plan, and educating them about the value of the coverage options.
  • The full list of recommendations and actions as of March 2006 is available in the table of details (PDF).

    Conclusion

    MIT must focus its efforts and resources where they are most needed and where they can create the greatest impact. The Medical Task Force Working Group is currently engaged in designing the best suite of health care options to meet the diverse needs of the MIT community.

    The Working Group will issue its next progress report in October 2006.

     


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