State House News Service Reports on Special Commission to Address Variation in Health Care Prices
Wednesday, September 7, 2016
ON HEALTH CARE PRICES, BEACON HILL POISED TO TEST SPECIAL COMMISSION ROUTE
By Katie Lannan
STATE HOUSE NEWS SERVICE
STATE HOUSE, BOSTON, SEPT. 7, 2016.....A 23-member special commission created as part of a deal to avert a ballot question will meet for the first time Tuesday to begin studying variation in prices among health care providers in Massachusetts.
The May law creating the commission was the result of a compromise worked out by Gov. Charlie Baker's administration and legislative leaders to avoid a costly ballot campaign fight over hospital pricing between Partners HealthCare and the health care workers union 1199 SEIU, both of which are represented on the commission.
The new law charges the commission with conducting a "rigorous, evidence-based analysis to identify the acceptable and unacceptable factors contributing to price variation in physician, hospital, diagnostic testing and ancillary services." The factors the commission will study include quality, medical education, service capacity, special services, market share, location and research.
The statute requires the commission to file any draft legislation arising from its recommendations by March 15, 2017.
In a statement, Baker said he looks forward to reviewing the recommendations and to "continuing to work with the legislature to resolve the matter of price variation."
Health care pricing issues have vexed the Legislature for years. While steadily rising costs are seen as a burden on government, business and family budgets, the health care industry is also a major source of jobs in Massachusetts and the Legislature has been reluctant to move toward price regulation, in part due to impacts on care providers but also due to philosophical differences about the role of government in the marketplace.
In addition to creating the commission, the health care financing deal directs $120 million over five years in financial relief to hospitals across the state.
Health Care Financing Committee co-chairs Sen. James Welch and Rep. Jeffrey Sanchez will lead the commission. Attorney General Maura Healey, Administration and Finance Secretary Kristen Lepore, Health and Human Services Secretary Mary Lou Sudders and Group Insurance Commission Executive Director Dr. Roberta Herman or their designees will serve as members.
Sanchez and Welch, in a joint statement Wednesday, said they hope the commission will "engage in a balanced and fruitful dialogue."
"Given the short timeframe of this commission, we plan to focus on the issues laid out in our statutory charge with a structure that will facilitate thoughtful policymaking," the statement said.
The commission includes eight gubernatorial appointees, which Baker announced on Tuesday. They are Steve Carey, vice president of human resources at Polar Beverages; Boston Out-Patient Surgical Suites administrator Gregory DeConciliis; Connie Englert, principal and managing director of TrueNorth Transit Group; Richard Frank, a health economics professor in Harvard Medical School's Department of Health Care Policy; Anna Jaques Hospital President and CEO Mark Goldstein; Dr. David Torchiana, the president and CEO of Partners Health Care; Kate Walsh; the president and CEO of Boston Medical Center; and 1199 SEIU executive vice president Tyrek Lee.
Other appointed members are Health Policy Commission Chairman Dr. Stuart Altman, Lahey Hospital and Medical Center President Dr. Howard Grant, House Majority Leader Ron Mariano, and Associated Industries of Massachusetts President Rick Lord.
Representing the health care industry are Blue Cross and Blue Shield of Massachusetts Chief Operating Officer Deb Devaux, Massachusetts Association of Health Plans President Lora Pellegrini, Massachusetts Council of Community Hospitals President Steven Walsh, Massachusetts Hospital Association President Lynn Nicholas, and Conference of Boston Teaching Hospitals Chairman John Fernandez.
The commission members will be sworn in prior to their first meeting, according to the governor's office.
Tuesday's meeting is scheduled for 11 a.m. in Room 428 at the State House.
The ballot question backed by the health care workers union, which aimed to aid community hospitals, would have set a floor and ceiling on negotiated prices between private insurers and health care providers.
Lawmakers have expressed a need to address the different prices charged by doctors, hospitals and other providers for similar treatment -- both to protect consumers and to keep the healthcare industry financially stable -- but many on Beacon Hill and in the health care field did not view the ballot proposal as the best approach, leading to the compromise and plans for further study of the issue.