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Massachusetts Health Care Reform – Full Speed Ahead; Health Policy Commission 2015 Cost Trends Report

The Massachusetts Health Policy Commission (HPC) has issued its 2015 Cost Trends Report, based on the HPC’s annual health care cost growth hearings. The report contained 13 key recommendations across a wide range of health care policy issues, all aimed at fostering initiatives to create an integrated strategy for tackling the benchmark-breaking rise in 2014 aggregate costs of 4.8%, which blew through the state’s benchmark of 3.6%.  Created by Chapter 224 of the Acts of 2012, as part of a comprehensive legislative approach, the HPC has a broad portfolio of responsibilities, including reviewing material changes in corporate and clinical affiliations, registering provider organizations, certifying (non-CMS) ACOs and patient-centered medical homes, and promoting alternative payment methods (APMs) and innovations in health care delivery.

The HPC’s proposals include increasing use of APMs, including bringing PPO enrollees under them and addressing perceived underlying provider price differentials; identifying what the state can do to tackle drug costs, while recognizing that federal action would be required for a successful strategy; addressing perceived problems with out-of-network billing; seeking to establish site of service equivalency; promoting greater integration of behavioral health and long-term care into payment and system reform initiatives; insurance product design; standardizing quality measures; and fostering more relevant price and quality transparency through recommendations for actions to be taken by its sister agency, the Center for Health Information and Analysis (CHIA), also created by Chapter 224.

Steve Weiner, who chairs Mintz Levin’s Health Law Practice, has authored a Client Alert that summarizes the 2015 Cost Trends Report and its key recommendations, and places them in the context of overall health care reform efforts underway in Massachusetts, where the nation looks to see trends and emerging issues.  Steve’s Client Alert coincides with ML Strategies/Mintz Levin’s 2016 Government Speaker Series kick-off event, featuring the HPC’s Executive Director David Seltz, who will share his outlook on the key trends driving activity in 2016.  Register here for the event, which takes place on Monday, February 1, 2016, from 12:00 - 1:30 pm Eastern at Mintz Levin’s Boston office.

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Author

M. Daria Niewenhous is a Mintz Member with a well-established health care practice. National and local providers rely on Daria’s experience to navigate capital projects, mergers & acquisitions, integration, and other strategic initiatives; adverse events; and licensing, contracting, patient care/risk management, and other complex legal matters.