State To Review Partners Contracts: Yes, But . . .

The Globe yesterday reported (http://www.boston.com/news/health/articles/2009/01/01/state_panel_to_examine_payments_to_partners/) that state officials will begin looking into the impact of contracts between the Partners hospital system and insurers.

Yes, but we’ve been waiting for months for an existing process on payments to get underway. The review announced yesterday may be worthwhile, and we hope the process is open and transparent.

But as we said when the first Globe spotlight story came out (see this blog post), the focus needs to turn to the systemic, structural reasons that lead to health costs being so high in Massachusetts. The structural issue was also raised in yesterday’s Globe, buried deep in Lisa Wangsness’ story on electronic medical records:

“Doctors get paid by the visit and procedure, not for keeping people healthy.”

The legislature and governor agreed last summer to legislation suggested by HCFA calling for a plan to completely overhaul the health payment system in Massachusetts. The law directed a special commission to meet and formulate a plan for “a common transparent payment methodology that promotes coordination of care and chronic disease management; rewards primary care physicians for improving health outcomes; reduces waste and duplication in clinical care; decreases unnecessary hospitalizations and use of ancillary services; and provides appropriate reimbursement for investment in health information technology that reduces medical errors and enables coordination of care.”

The panel was directed to start up last September, and make its report in April. So far, nothing has happened. We keep hearing that the delays are caused by the time it takes to vet the 5 public members of the panel. We’ve been told for months that the commission would be starting “very soon.” It seems to us that if this was a priority, it could have happened already.

While it will be valuable to look back at the payment levels agreed to by hospital systems and insurers in the past, it is more important to reform our payment structures going forward. The ideas on how to fix the system are well known (see this report for a good summary of many of the proposals). The role of the commission is to marshal the political support needed to implement the plan. It’s time to start that process.
Brian Rosman