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Thoughts from James Roosevelt, Jr., MHQP’s Imcoming Board Chair

The MHQP Board of Directors has elected James Roosevelt, Jr., as its new Chair. Mr. Roosevelt succeeds Meredith Rosenthal, who served as Board Chair for five years and will be stepping down as Board chair. The transition will be effective January 1, 2018.  Here are some of Jim’s thoughts as MHQP’s incoming Board Chair.


What was your reaction when you heard about your appointment?

It’s a very exciting time to be taking this role at MHQP because I believe the consensus in the nation has moved to how do we provide people with access to healthcare, rather than should we provide access to healthcare, which is where it was ten years ago. We are farther along that continuum here in Massachusetts than elsewhere, but we are subject to the national pressures, particularly around federal funding, as well. So, it’s exciting to have the opportunity to play a positive, visible role in keeping quality front-and-center in the discussion about how we provide universal access to healthcare.

What compelled you to take this position? What is appealing about MHQP for you?

Well, I’m a former Member representative to MHQP and I have been a strong observer of MHQP from the beginning. I’ve always been impressed with the leadership that MHQP has shown and thereby made Massachusetts an example of collaboration in achieving quality in healthcare – or I should say, continuing to pursue quality in healthcare, because it’s never a static achievement.

How have you perceived that MHQP has played that role over the years that you’ve observed or been involved with the organization?

Over the last couple of decades, we have learned that healthcare does not succeed in silos. Providers by themselves, payers by themselves, consumer advocacy organizations by themselves, cannot achieve the quality results, including the outcomes, that we all want in healthcare, while at the same time achieving the cost goals that we have agreed upon here in Massachusetts. It just doesn’t work in silos. You end with people at cross-purposes or you end up with frustration. There’s a great opportunity to avoid duplicative and sometimes competing goals. That has existed and, even with all the progress we’ve made, that has continued to exist.

So, it is the collaboration of institutional providers – that is to say, hospitals and health systems – and direct providers and payers and patients in setting goals and working toward common measurement that is largely responsible for the success we’ve had so far.

MHQP is about measurement and having the measurement be accepted across the healthcare field, as opposed to being out there and being grudgingly referred to or sniped at. Our role is to get to consensus so that all the segments of healthcare delivery and payment are enthusiastically – not just willingly, but enthusiastically – embracing the quality goals that serve the patient most fully. The patient voice and our involvement of consumers provides an important piece of that. This is even more necessary as we try to work in today’s healthcare environment.

MHQP was founded because of the need for neutral territory and collaboration in the early days of quality improvement and measurement. How do you see it as different today and what role do you think the organization should play going forward?

At the outset, achieving a neutral territory, not just sort of grudging compliance with standards that others have set, was very important. Although there have been real successes in that area, I don’t think the need for that has diminished. In fact, I think there’s an even greater opportunity now that we are at essentially universal coverage here in Massachusetts, because we are now treating people of every socio-economic level, of every health status level in a way that just did not begin to be possible until about ten years ago. We’ve always had a higher level of coverage than the rest of the country, but we still had very large segments of the population without coverage. It was much easier to achieve quality goals when we didn’t have segments without healthcare coverage involved, because they tended to be people who just did not have access to healthcare. The fact that they were not receiving treatment actually made us look like we were doing better than we actually were, because their outcomes were not part of the calculation.

MHQP’s role in this environment is something of a continuation of its ongoing role in terms of having common measures rather than competing measures. But I also think there’s a very important role in terms of identifying newly-served segments of the population and identifying where there is a bigger challenge in getting to good quality in those segments of the population.

Now that we can really talk about serving all of the population of Massachusetts, there are going to be pockets where there needs to be greater success. I don’t want to call it resistance because that implies that people don’t want it to happen. I’m talking about where it’s harder to make it happen because of a history of lack of access to healthcare that we’re now at the point of overcoming.

Do you envision MHQP competing effectively with the other organizations that provide measurement services or organizations that do their own measurement? What does MHQP bring to the table that’s a unique value?

I believe that MHQP has the opportunity to provide common measures that wouldn’t exist otherwise. It’s great that the systems are doing their own measurement in some cases, but unless there is reliable, agreed-upon common measurement, people won’t know how the organization is doing, they won’t know how they compare to others, and – this is where the voice of the patient comes in – consumers won’t be able to compare between organizations. So, that’s where I think a collaborative, agreed-upon approach is still valuable, even when organizations are doing their own measurement in a more active way. There’s a tendency, probably in all human endeavor but especially in healthcare, to have measures that are not common and you lose the ability to really see whether there’s success or whether you are just inwardly focused. Commercial measurement organizations obviously do very valuable work, but I think that MHQP has an opportunity to provide broader consensus and more participation.

How do you think your skills and background synch up with what MHQP needs at this time in its history? What do you see as your unique capacity and contributions to the organization going forward?

I have experience as a healthcare lawyer representing all segments of healthcare, and then as a hospital board chair and as a hospital association board chair, and then as CEO of a major payer in this market. So, I think I can contribute to the role as Chairman of MHQP by having firsthand – not just theoretical, but firsthand – experience with the points of view of all the various participants.

What do you see as the greatest strengths of the organization right now?

I think the organization has grown stronger because of its governance reorganization, which I think gives it a more effective way of identifying what the current needs are. I think it continues to have great strength in its staff. It continues to have the confidence of all segments of healthcare delivery and payment, as well as activist healthcare consumers. I think those are all strengths of the organization. And I think the recent award of the contract from the Commonwealth is the product of those strengths.

And what do you see as the biggest challenges for the next 5-10 years?

The biggest challenges are going to be, with all the pressures on cost, and with the continuing debate on how coverage is achieved, we also need to get people to recognize that lower cost and greater coverage are useless if they’re not producing quality healthcare. And we have to keep getting people to recognize that it’s worth spending some money on that proposition.

Lastly, what would you say are your hopes and dreams for MHQP?

I believe we in Massachusetts have a commitment to access to healthcare and quality of healthcare that is unique in the United States. I don’t think there’s any other geographic or political entity that is as committed to making quality healthcare as universal as Massachusetts is. And I think that continuing to relate that commitment to universal access, quality treatments and outcomes, and I would say even lifestyles – which is where patient engagement comes in – is the driving force behind MHQP. So, my hope and dream for MHQP is that that will continue to be true and be recognized.

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