Earlier this month, the Quality and Cost Council established an ad hoc committee to discuss steps to achieve a key Council goal: “Reduce the cost of health care. Reduce the annual rise in health care costs to no more than the unadjusted growth in Gross Domestic Product (GDP) by 2012.” The ad hoc committee met today to draw up a list of recommendations to present to the full Council on 1/1/08. Today’s discussion focused on a list of options to reduce health care costs.
AG Martha Coakley’s rep, Quentin Palfrey, had the session’s money quote (from SH News):
“Nothing is taboo. Everything is on the table. This is potentially a crisis that could doom health reform if we don’t do something about it. We really need to think about even controversial things and we need to get our hands dirty,” said Quentin Palfrey, chief of Attorney General Martha Coakley’s health care division. “I don’t want to shy away from the notion that there may be tough medicine involved in the process.”
Recommended Step #1: The Council, with technical assistance from independent experts, will develop legislative, regulatory and other recommendations to control health care costs, and the Council consider these options, among others (each categories includes more specific examples):
• Rate regulation (insurers and providers)
• Controlling supply of services – revamped Determination of Need
• Reorganization of health care delivery systems
• Dissemination of information on clinical and cost effectiveness
• Payment system reform
• Malpractice reform
• Concentration of market power
• Consumer and employer demand and expectations of services
The recommendations shall include an estimate of cost savings and recommendations for implementation and tracking. The options will be prioritized by the Council, with assistance from experts, by effectiveness, ease of implementation and impact on access, quality and racial/ethnic disparities.
Recommended Step #2: The Council will adopt a standard of measurement of total annual health care spending in MA (the “MA Global Health Cost Indicator”) to track the annual increase (or decrease) in costs in total and within health care sectors.
Recommended Step #3: The Council will contract with independent experts to analyze causes of increases (or decreases) in health costs, including effects of: supply and demand for services and utilization trends; concentration of provider market power (by region and medical services); concentration of insurer market power; quality of care and avoidable medical errors; administrative costs; payment systems; overuse and inappropriate use of medical technology; and medical devices and pharmaceuticals.
Recommended Step #4: The Council will contract with independent experts to assist in preparing reports to the Governor, EOHHS Secretary, Senate President, Speaker and Chairs of the Committees on Ways and Means and Health Care Financing comparing variations in rates paid by insurers, insured health plans, self-insured entities, Medicare, Medicaid, uninsured person and other payers to health care providers in the Commonwealth within the constraints of disclosing proprietary information.
One concern was that the Council’s work on cost containment could become irrelevant if they don’t move quickly because there is movement at the State House and elsewhere. HCFA’s cost agenda includes 17 proposals to reduce health care costs and we are promoting legislation on these proposals. Learn more about our costs proposals by clicking here.
Great to see the Quality and Cost Council taking a leadership role in this.