Getting Real in Massachusetts

posted by Penelope Lemov

The knock on Massachusetts' universal health reform  package is that it does nothing to address the root cause of unaffordable health insurance: the high price of health care.

Last week, the state stepped up to the plate.

Legislators didn't go back to the usual pitch: shrink payments to providers; cut back on health services available to beneficiaries. They wrote into law some measures that could actually help tame costs in the Bay State.

One piece of the bill goes after inefficiencies. It calls for a commission to develop uniform billing and coding standards for health care providers and insurers and it sets a statewide goal of adopting electronic health records by 2015 .

The bill also takes on the problem of primary care--fewer physicians go into the field and that pushes patients into higher-care settings for basic health care. What the Massachusetts law calls for is expanding enrollment at the UMass medical school and providing incentives for students to go into primary care specialties.

It's a start.

Comments

[Brian Rosman]

You've just scratched the surface of this many-faceted bill to address cost control.

-The bill directs a state agency to conduct hearings on cost drivers among hospitals and insurers.

- the bill sets up an "academic detailing" program to educate doctors on cost-effective drugs

- the bill tightens the determination of need process for surgery centers

- the bill prohibits billing for never events and requires public disclosure of hospital infections

- the bill authorizes medical homes for Medicaid

- the bill sets up a small commission of stakeholders to recommend a new payment system that rewards health and wellness instead of more intensive services, and calls for applying for a Medicare waiver so that all payers are using the same system.

There's more than this, too.