HEALTH: Senate report, draft law seeks to rein in costs, improve care

Mass. General, Brigham's lodge objections

Leaders of the state's two largest hospitals made a rare appearance Monday, Oct. 23, on Beacon Hill to warn state senators against approving any policies that would slash their revenues.

State Senate leaders, as part of a sweeping bill designed to improve the state's health-care system and control costs, seeking to curb hospital spending. The plan would allow for higher insurance reimbursements for the state’s least expensive hospitals, while potentially fining the hospitals where spending is highest.

The heads of Massachusetts General and Brigham and Women's asked lawmakers to reject any measure that would punish the two academic medical centers. Read The Globe's Oct. 24 story here >>

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UPDATED, Oct. 24: The state Senate has released a health-care report that focuses on both short- and long-terms goals aiming to lower costs, improve outcomes and maintain access.

The report and accompanying draft legislation are the result of effort by a group of senators, including Cindy Friedman, Democrat of Arlington, to address the health-care system by analyzing the best practices in other states and engaging stakeholders in a series of meetings over the last year.

A hearing on the report, titled "Working Together to Improve Our Health: Right Care, Right Place, Fair Price, Recommendations from the Senate Working Group on Health Care Cost Containment and Reform," and draft legislation was set for 11:30 a.m. Monday, Oct. 23, at the State House. Read a copy of the report and draft legislation here >> 

"Attempts to control health-care costs within the present private insurance system have failed, and costs have steadily consumed more state, municipal, business and household budgets," Friedman said in an Oct. 19 news release. "This legislation is a step in the right direction in addressing rising health-care costs that have put a strain on many families in our state. I look forward to working with my colleagues to strengthen the bill to ensure that we continue to develop the most efficient way to deliver high-quality health-care coverage to consumers at a fair price."

Rosenberg comments

Senate President Stan Rosenberg, Democrat of Amherst, said in the release: "Massachusetts should continue to lead on health care, and having a robust economy depends upon on lowering costs for everyone without compromising quality or access. The recommendations in this report will help working families, businesses and our state budget. I'm very proud of the work the Senate did to craft a comprehensive report and draft legislation that touches so many aspects of our health-care system and meets the needs of all engaged stakeholders."

Health-care costs are continuing to strain the budget of working families, businesses and working families. The Senate has continued to push for reforms to the current system through diligent research, stakeholder engagement, and legislation. The working group of Senators, with the logistical support of the Milbank Memorial Fund spent the last year meeting with officials from seven states, healthcare experts and stakeholders to examine best practices while lowering costs and improving outcomes.

The goals outlined in the report vary from more effective care delivery, such as telemedicine and mobile integrated health to reducing emergency room visits to expanding provider versatility while also addressing price variation between larger hospitals and their smaller community hospital counterparts. The report outlines a series of recommendations that aims to achieve these goals and lower costs.

The report targets reducing hospital readmissions and emergency department use through mobile integrated health and telemedicine as well as expanding access to behavioral health. Massachusetts Health Policy Commission has estimated that 42 percent of all Emergency department visits are avoidable.

Post-acute care in an institutional setting and long-term care and supports cost the state an estimated $4.7 billion in 2015, a major cost driver for MassHealth. The report recommends increased transition planning for patients into community settings and strengthening coordination between providers.

Pharmaceutical costs have been a driver of increased health-care costs for a number of years. The Center for Health Information and Analysis reported a 6.4-percent growth in pharmaceutical spending in 2016. Drug costs are making families choose between filling prescriptions and paying for other essentials, such as housing and food. The report recommends greater oversight and transparency in drug costs and encourages Massachusetts to enter into bulk purchasing arrangements, including a multistate drug-purchasing consortium, as other states do, to lower costs and protect consumers.

The scope of the report encompasses the whole system from Medicaid to the commercials market, and makes additional recommendations about how to lower costs, address price variation, increase price transparency for consumers and leverage better federal-funding opportunities.

Last year, the Senate created a Health Care Cost Containment Working Group with hopes of creating legislation to not only reign in health-care costs, but also empower consumers, boost innovation and care delivery, and foster a fair and functioning commercial market. "This bill is the direct result of this working group’s efforts,” said Sen. Jim Welch, Democrat of D-West Springfield, Senate chair of the Committee on Health Care Finance and leader of the working group. 

This news announcement was published Saturday, Oct. 21, 2017.