Massachusetts
Massachusetts isn’t using a tool that could help tackle its shortage of primary care doctors – The Boston Globe
When Massachusetts is a national outlier in any policy, it’s worth asking why and whether that policy still makes sense.
Massachusetts today is one of only seven states that does not use Medicaid money to fund medical residencies, which provide the clinical training of new doctors after they complete medical school. Among the 10 states with the most teaching hospitals and physician residents, it is the only one that does not use Medicaid money to support graduate medical education, or GME, according to the Association of American Medical Colleges.
The main reason appears to be cost: Massachusetts did have a program, but policy makers cut it in 2010, according to the Executive Office of Health and Human Services, amid budget shortfalls due to the 2008 recession and as state officials prioritized implementing universal health insurance coverage.
Today, cost remains a barrier to reinstating the program. Yet given the shortage of primary care physicians, lawmakers should consider reinstating Medicaid GME in a targeted way that shores up needed services like primary care, behavioral health care, and community health centers.
Without the Medicaid money, residencies are mostly paid for by Medicare, which gave $16.2 billion in fiscal 2020 to GME programs nationwide.
Although it may seem like an arcane distinction, there are two good reasons to use Medicaid money to fund residencies beyond those funded by Medicare. One is that the federal government would match the state contribution, drawing new federal money. The second is that the state can narrowly tailor a Medicaid program to decide how much money to spend — and how to spend it.
This flexibility means state lawmakers could target money for residencies in specific specialties that Massachusetts needs more of.
There is a dire need to train more primary care physicians and keep them in Massachusetts. People are struggling to find doctors. Wait times at community health centers, which see many Medicaid patients, have recently been as long as 80 days for a new patient and up to 40 days for an existing patient, according to Michael Curry, president and CEO of the Massachusetts League of Community Health Centers.
According to the Milbank Memorial Fund’s primary care scorecard, 16.7 percent of adults in Massachusetts and 5.4 percent of children in 2021 lacked a usual source of health care, numbers that had grown since 2011. According to survey data from Massachusetts Health Quality Partners and the Center for Health Information and Analysis, adults were having a harder time accessing primary care in 2022 than in 2019. Massachusetts has a higher rate of doctors leaving primary care than the nation overall. One-third of Massachusetts doctors in 2020 were over 60 and fewer than one-quarter of Massachusetts medical school graduates are entering primary care, according to MHQP.
When someone cannot get an appointment with a primary care physician, they are more likely to become seriously ill and go to the emergency department, at a time when hospitals are experiencing capacity crunches.
Funding more residency training slots through Medicaid would not magically solve the problem. Seriously addressing the primary care shortage will require paying primary care doctors more and addressing the administrative burden that makes primary care such a hard job. Massachusetts officials are taking other steps to address the problem, like establishing student loan repayment programs.
But reestablishing Medicaid GME could allow hospitals and community health centers to train more doctors to work in badly needed fields. Because specialty care is more lucrative, without the added Medicaid incentive, hospitals are more likely to create residencies in specialty fields than primary care.
Multiple bills to reestablish Medicaid GME payments are pending in legislative committees, with advocacy by the League of Community Health Centers and the Massachusetts Health and Hospital Association. The details differ, but the basic idea is to pay for residencies in fields with shortages, including primary care and behavioral health care, in hospitals and community health centers. (Like primary care, behavioral health care is a field where worker shortages are severely impacting people’s ability to get timely care.) A program could also potentially fund training for non-physician clinicians, like nursing students.
The League of Community Health Centers is asking for $50 million in Medicaid funding over three years, half of which would be reimbursed by the federal government. According to the organization, that level of funding would pay to graduate 23 new family medicine doctors annually (with funding for three years of residency) and to fund 69 residency slots each year for nurse practitioners, assuming a cost of $185,000 per physician resident and $120,000 per nursing resident.
Most states use general fund money to pay for Medicaid GME, though some rely on municipal tax money or taxes on hospitals. Lawmakers will have to determine the best funding source.
But the money is likely to be a smart investment, and it will draw in federal money that the state is leaving on the table now. And if increased funding for residencies means more doctors go into primary or behavioral health care in Massachusetts, patients will be seen sooner and will get the care they need to remain healthy, lowering costs in the long term.
Editorials represent the views of the Boston Globe Editorial Board. Follow us @GlobeOpinion.
Snow flurries are expected to sweep across Massachusetts on Saturday morning, with some areas of the state potentially receiving up to three inches of accumulation by the end of the day.
The snow is “expected to be light and fluffy in nature given the cold atmosphere,” according to the National Weather Service.
It’s expected to taper off from west to east later in the afternoon.
Western Massachusetts and Worcester will likely see the lightest snowfall. These areas, with a high of 31 degrees, can expect less than an inch of accumulation, while Springfield may only see a dusting.
The Berkshires, where temperatures may struggle to reach 28 degrees could see up to an inch of snow.
Eastern parts of Massachusetts are expected to see the most snowfall. Boston, with a high of 33 degrees, may see around two inches of snow.
However, Essex County could reach three inches by the time snow wraps up after 8 p.m., the National Weather Service reported.
Cape Cod may have milder temperatures with a high of 35 degrees and is expected to see the least amount of snow, which will likely be less than an inch.
BROOKFIELD – The Brookfield community gathered for a candlelight vigil Friday night, marking two years since the disappearance of 35-year-old Brittany Tee on January 10, 2023.
The community packed the Brookfield Congregational Church, surrounding the family and vowing to keep looking for Brittany.
Since that January 10th day, her family has been carrying an unrelenting weight on their hearts, not knowing where she is.
“Where is she? What happened to her?”
“They say time heals all wounds, but I disagree, not when your family member disappears out of nowhere without a trace,” said Brittany’s sister Bethany Tee. “Time is making that wound bigger. There is no healing, no closure, just daily heaviness in your heart and constant thoughts of worry. Where is she? What happened to her? Is she safe? Are we doing enough?”
The 35-year-old was last seen leaving the Main Street house she shared with her boyfriend that Tuesday evening. Despite efforts to reach her, she was never seen again.
A nearby river and woods have been searched extensively with no results.
DA attends vigil
Worcester Country District Attorney Joseph Early joined the vigil to assure the community investigators are still working the case.
“It doesn’t always happen as quickly as we would like, and that’s the tough part, that’s tough, the anxiety, the wonder,” said DA Early. “But I can tell you this, everything they do they do it better than anyone I’ve ever seen.”
Two years later, they hold onto every hope, hug, kind word and prayer, refusing to give up on finding Brittany.
“We are not giving up; we will never give up. We love and miss you Brit and we’ll bring you home,” said Bethany Tee.
The night she was last seen, Brittany wore a black winter coat, a hoodie, jeans, and work boots.
An anonymous tip line has been set up at (508) 453-7589. People are encouraged to call if they know anything or something comes to mind.
Massachusetts
EZDriveMA text message scam resurfaces. Here’s what Massachusetts drivers should do if you get one.
BOSTON – A texting scam targeting drivers in Massachusetts has resurfaced. It claims that drivers owe money for unpaid E-ZPass tolls through EZDriveMA.
The scam first appeared back in June and recently surged again during the holidays, according to the Massachusetts Department of Transportation (MassDOT).
EZDriveMA scam – how it works
The scammers target drivers using “smishing” where they send a text or email saying they are part of the tolling agency. They claim that a driver has an unpaid toll and that they should settle their bill using a link provided before late fees occur.
“They’re really playing to your psyche, asking you to make sure you avoid these charges and try to do the right thing. And unfortunately, it really gets people roped in,” MassDOT Highway Administrator Jonathan Gulliver told WBZ-TV Friday.
MassDOT urges customers to never click links sent by unknown numbers or emails. They emphasized that they will never send a bill or any information through a text message.
Gulliver says the scam targets people with phone numbers near tolling authorities. The scammers do not have any specific information about their targets but hope to get personal and financial information through the link. He said that he personally received one of the messages.
Dartmouth Police issued a warning to residents about the scam making the rounds again, saying that an officer personally received one of the messages.
What to do if you receive a scam text message
If you think you have received a scam text message, officials say you should not click on any links, do not respond to the message, and do not give out any personal information. They advise people to ignore the message completely and delete it before interacting with it.
If you are concerned about a message, you can validate the authenticity of it by going directly to the toll website or calling the toll authority at 877-627-7745.
If you have already clicked on a link, MassDOT recommends taking precautions to secure your financial and personal information and disputing any unknown charges through your bank.
“First thing you should do, don’t call us. Call your bank or your credit card. If you have already given them some information, make sure you put a hold on whatever account you have, work with their fraud unit to make sure that you’re not exposing yourself to anything more,” Gulliver said.
If you believe you have received one of these scam text messages, you can file a complaint with the FBI through the Internet Crime Complaint Center (ICC).
Past E-ZPass scam
This type of “smishing” scam surged in Massachusetts in 2024. The scam similarly included an invoice advising people to settle an overdue EZDriveMa bill using a provided link.
A retired FBI agent said the scam was successful because it collected cash in small amounts and that people may not have been aware that they had passed through a toll.
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