Dr. Michael D. Miller (not the other Michael Miller) of the Health Policy and Communications Blog has a terrific post summarizing and offering perspective on the Massachusetts payment reform proposal.
His conclusion: “if the state of Massachusetts can implement the Special Commission’s recommendations for an all-payer global payment system in ways that transform healthcare delivery, it will be the most significant health reform initiative in the United States since the creation of Medicare and Medicaid in 1965.”
While Massachusetts has been pointed to as a model for national health reform – and the state should be proud of achieving near universal coverage – shifting the health system’s fuel source from volume to quality will be a much more profound achievement with longer lasting implications. After taking significant steps to increase insurance coverage to >97%, payment reform and delivery system transformation are the next logical tandem steps. Nothing else being discussed at the Federal level or in other states would have as sweeping an impact as going to an all-payer global payment system. …
Next Steps
The state legislature is expected to start hearings on the Special Commission’s recommendations in September. At this point the major stakeholders – including insurers, doctors, and hospitals – are supporting the recommendations. Health reform advocates should start paying attention and figuring out how to mobilize support for the legislature to implement these recommendations so that no matter what happens with Federal reform, Massachusetts will be ahead of the curve in taking real steps to bend the spending growth curve. And if there is no Federal legislation this year, Massachusetts will be even farther ahead of the curve and positioned to lead the rest of the nation as well as create a more economically attractive environment for starting businesses and creating jobs – while improving the quality of healthcare.
Dr. Miller emphasizes that the new global payment structure needs to transform medical practice. Incentives and accountability have to filter down to the individual practice level. He urges health reform advocates to jump into the fray. We’ve started by organizing consumer and coming up with our preliminary principles.
Are we up for the challenge?
-Brian Rosman
