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Key Findings

• In the absence of policy change, health care spending in Massachusetts is projected to increase about 8 percent faster than the state's GDP over the next decade.
• There are no silver bullets for closing that gap, but there are multiple options that would reduce spending.
• The most promising cost-containment options involve changing methods of paying for health care services.
• Some infrastructure-related options, such as increasing use of health information technology, will not produce substantial savings themselves but are needed to implement other policies.
• Some popular strategies, such as disease management and medical homes, do not appear likely to yield substantial savings.
• Two factors explain why some options are more promising: the size of the population affected and a clear mechanism for changing the price or quantity of services.
• Estimates of savings from all options are very uncertain because none has a proven history of reducing spending.

In 2006, Massachusetts passed landmark legislation ensuring near-universal health insurance coverage to residents of the state through a combination of mechanisms. By 2008, only 2.6 percent of Massachusetts residents were uninsured, considerably below the national average of 15 percent.