Quality and Cost Council Discusses Quality Measures

The Health Care Quality and Cost Council met Wednesday with a full agenda (pdf). Administrative Director Jessica Moschella updated the council on the status of the Annual Report, which has been submitted, her presentation to the Rhode Island Senate on Massachusetts’ experience on quality and cost, and the recent release of the report on “Patient-Centered Care and Human Mortality” (pdf) by the Massachusetts Expert Panel on End of Life. DPH Commissioner John Auerbach stated that the Public Health Council will be coming up with a few quality measures based on the report.

One issue that aroused a lively discussion was the proposed 2011 quality measures for the states health quality rating website, MyHealthCareOptions. A handful of new measures were proposed. At one point, there was a discussion regarding the consumer-friendly nature of the available measures and whether patients will be able to use the information that is provided to them. We were glad to see that most members were supportive of quality and cost measure transparency and believed that people will be able to make good use of such measures in making their health care choices. The measures were approved with a unanimous vote, after Secretary Bigby’s thoughtful comment that people normally don’t consider themselves as a collection of organs and that the measures will, at some point, need to be categorized according to illnesses rather than organs.

Another round of discussions occurred during the overview presentation of the Governor’s new payment reform bill. Kevin Beagan of the Divison of Insurance explained to the Council the authorities it will have under the current language of the bill, which includes rate review. Beagan clarified that rate review is not rate setting, because providers and payers would still be able to negotiate the rates as long as it is within the boundaries of what the DOI determines as appropriate based on the estimated parameters. Some council members raised concerns on how the DOI would perform rate review under global payment and other alternative payment models.

One clarification that was a welcome news for consumers was that the current Governor’s bill does not intend to curve out mental and behavioral health from the coordinated health care services that need to be provided under the new payment models. All the council members, including the Secretary, agreed that any payment reform must include mental and behavioral health as a part of the services that are provided under models such as ACOs.

The Secretary ended the meeting by stating that any cost savings that result from payment reform must be shared with the consumers and other purchasers of coverage.
-Jekkie Kim

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