Tuesday, August 7, 2012

Massachusetts on Overdrive

The Commonwealth of Massachusetts just enacted an even more restrictive Health Care Plan than the ACA or so it appears. In a Press Release today they state:

The new law will:

Achieve Billions in Savings: Sets a first-in-the-nation target for controlling the growth of health care costs. The law holds the annual increase in total health care spending to the rate of growth of the state’s Gross State Product (GSP) for the first five years, through 2017, and then even lower for the next five years, to half a percentage point below the economy’s growth rate, and then back to GSP.Results in nearly $200 billion in health care cost savings over the next 15 years, which will lead to up to $10,000 in additional take-home pay, per worker, over 15 years.The average family will see an estimated savings of $40,000 on their health care premiums over 15 years. 

Move to Alternative Payments: To control costs and improve quality of care, the law requires government agencies like MassHealth, the GIC and the Connector to use global and other alternative payments to achieve savings for taxpayers. Encourages alternative delivery systems across health care fields to deliver additional savings for patients, business owners and working families.

Increase Transparency: The law also gives consumers better information about the price of procedures and health care services by requiring health insurers to provide a toll-free number and website that enables consumers to request and obtain price information.

Address Market Power: To monitor and address the market power and price disparities that can lead to higher costs, the law allows a Health Policy Commission to conduct a cost and market impact review of any provider organization to ensure that they can justify price variations. The law identifies triggers for when a provider or provider organization will be referred to the attorney general for investigation. An independent Center for Health Information and Analysis will conduct data collection and reporting functions.

Promote Wellness: The law creates a Wellness Fund of $60 million administered by the Massachusetts Department of Public Health for competitive grants to community-based organizations, health care providers and regional planning organizations. 

Enact Malpractice Reform: The law includes malpractice provisions proposed by Governor Patrick, requiring a “cooling-off” period before a party may initiate a suit, while making providers’ apologies inadmissible as evidence. Many studies show that an apology can prevent a lawsuit but due to the threat of litigation, providers have oftentimes remained silent. 

Support Health Information Technology Massachusetts is already a national leader in adopting electronic health records and health IT efforts. The law complements these efforts, by advancing several health information technology programs, including the Executive Office of Health and Human Services' work with the Obama Administration to build and operate the statewide health information exchange.

 It appears however that what was enacted was a price cap mechanism on the provision of services. What also seems confusing is that if we have ACA then what is the State doing with regard to this? This has thus become a confusing nightmare for Massachusetts hospitals as well as physicians. They now see conflicting legislation and almost instantaneous reimbursement reductions, with a similar reduction on Medicare as well.

The Teaching Hospitals it appears will suffer the most. It will be interesting to see what happens in the long term. Medical education may become what we now see in Teacher education. A disaster!