A Quartet of Opinions on Mass Payment Reform

Today Kaiser Health News published a quartet of opinion on payment reform in Massachusetts. The pieces are by Governor Patrick, HCFA’s Paul Williams, Mass Hospital Association head Lynn Nicholas, and Dr. Lynda Young of the Mass Medical Society.

The introduction states that the Massachusetts Association of Health Plans did not respond to invitations to comment.

Governor Patrick reports on the progress his administration has made so far in using DOI’s regulatory authority to dampen cost increases, but acknowledges that “While an admittedly blunt tactic, and not in and of itself a long-term solution, it was a necessary step to galvanize the market to act.” He calls for action “to accelerate this transition to innovative, sustainable models in which incentives are realigned to reward integrated care that emphasizes wellness and lowers costs for everyone. Our goal is for integrated, cost-efficient caregiving to predominate throughout Massachusetts by 2015.”

MHA agrees that all parts of the health industry must work to constrain costs. In her comment, Nicholas calls on the state to set spending limit goals. “The strategies we pursue also must harness the ability of the private market to innovate and adapt quickly. At the same time, the government should work to improve its own programs by ensuring transparency, measuring success and helping to shape decisions among stakeholders about what to do if success isn’t realized.” She also calls for adequate reimbursements from government payers.

Dr. Young’s commentary for the MMS looks at how medical practices have adapted to increase in coverage since 2006. “To meet the new level of demand, many practices found it very helpful to hire physician assistants, nurse practitioners and other allied health professionals to help them improve the daily operations of the practice. Most patient visits require relatively simple interventions, while others are more complex. These health professionals can help physicians focus more of their time on the most complex and demanding visits.” Now conversations with patients are turning to the cost of care. Physicians must engage patients in these honest discussions.

Finally, on behalf of HCFA, Williams sets out some of the key goals of the Campaign For Better Care. We are urging that social factors be taken into account in risk adjustments, so that more vulnerable patients can receive the services they need. We also support patient engagement, tying payment to outcomes, like preventable readmissions, and investing in public prevention programs.
-Brian Rosman

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