In addition to moving forward the conversation on additional revenue sources for health reform phase 1, yesterday’s BCBS of MA Foundation summit signaled what may be a new consensus that fundamental payment reforms must be part of health reform phase 2.
Speaker after speaker made the same point. Speakers representing physicians (Dr. Jacqueline Spain, Medical Director of the Holyoke Health Center), hospitals (Lynn Nicholas, CEO of the Massachusetts Hospital Association, insurers (Andrew Dreyfus, Blue Cross Blue Shield Executive Vice President), researchers (Anne Gauthier, Commonwealth Fund), legislature (Senate President Therese Murray and Speaker Sal DiMasi) and the administration (EOHHS Secretary Dr. JudyAnn Bigby) all agreed: reimbursement should reward efficiency, value and preservation of health, not volume of services. Primary care must be reimbursed better. Transparency and accountability must be part of the system. The old system must go.
Secretary Bigby announced a pilot project to report readmission rates to hospitals, as the first step towards the goal of not paying for preventable readmissions. She also spoke on the medical home initiative, which is moving forward.
Payment reform was also among the cost control strategies discussed at the launch of the Coalition For Affordable Health Care on Wednesday. Several of the speakers at the gathering of insurers and employers, including Mass Association of Health Plans President Mary Lou Buyse and Associated Industries of MA Vice President Eileen McAnneny, stressed that today’s payment system drives over-utilization and higher health care costs.
Our current health care payment structure has been based on private negotiations between large insurers and large provider groups. The result has been unsustainable cost growth. Initiatives such as the Senate President’s proposal for cost driver hearings, and the Quality and Cost Council’s public release of price data, will help diagnose the problems. Other proposals, such as restrictions on duplicative technology and increasing our primary care workforce will make a real difference. But only a transformative change in the way we pay for medical care can fundamentally alter the health cost trajectory.
The Speaker told the group that the House will soon take up the cost control legislation passed by the Senate. The growing consensus revealed in the many conversations about cost control shows that another aligning-of-the-stars opportunity, like that of chapter 58, may be at hand. We’ve put many ideas on the table. Here’s one more: the cost control bill should direct that a committee, jointly chaired by the House, Senate and Administration and with a small group of stakeholders as members (no “blue ribbon commission”), come up with an all-payer (including Medicare) payment structure that the Commonwealth would file as part of a request for a Medicare waiver with the new President next January. The state could use some of the Medicare and Medicaid savings to invest in needed improvements to the system.
Brian Rosman
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Dreyfus, who started is well-paid stint at BCBS as the guy doling out the hush money from Blue Cross and Blue Shield MA to Health Care for All and every other “advocacy” group with a staff and a budget… and now Dreyfus was promoted to a Vice President! Surprise, surprise. Wonder if he’ll get a similar $20Mil payout when he leaves, as did Bill VanFaasen.
Anyone know how much BCBS exec Peter Meade got when he recently left MA BCBS to work for an ad agency that has BCBS as a client? As long as we’re on the topic of health care “cost control” it surely is relevant, isn’t it???
P.S. Brian, your blather about “John taught us…there’s the conversation then there’s the game…” is truly pathetic. Don’t you get it yet? HCFA MA is now a part of the PROBLEM, not the solution? Time to redeem yourselves before more lives are needlessly lost and more hundreds of million$ are squandered on this fake “reform” law.