Lawmakers overwhelmingly passed a 350-page health care cost-control bill Tuesday afternoon, a compromise between House and Senate leaders that sets spending targets for hospitals and doctors in the state and penalizes those that exceed them.
Governor Deval Patrick said he would sign the bill. “This is more than a good bill; this is a great bill,” he told reporters after visiting a Roxbury organization that seeks to reduce youth violence. “This is a commonwealth that has shown the nation how to extend coverage to everybody and to do it in a hybrid system with an emphasis on private-sector insurance with subsidies for those who can’t afford it. And now we’re going to crack the code on cost control.”
He said he does not believe the legislation will lead to layoffs in the health care sector or hospital closures. “There are going to be changes,” Patrick said. “But if those changes mean we get lower-cost and higher-quality care because care is being delivered in different settings—in homes, for example, in neighborhoods, in communities, rather than in hospitals—then I think that’s something we all ought to strive for and will strive for.”
Meanwhile, interest groups continue to send in their take on the bill.
The Massachusetts Medical Society outlined its likes and dislikes of the bill. Society president Dr. Richard Aghababian said he is glad the bill strikes a middle ground between the House and Senate’s proposed spending targets, encourages more transparency, presents a new model for allowing doctors to disclose and apologize for errors without fear it will be used against them in malpractice suits, and sets goals to grow the health care workforce to address shortages.
As for the group’s concerns, he cited the burden placed on small physician practices and the expanded scope of drug store clinics, called “limited service clinics”:
· We are concerned about the impact of the bill’s very stringent reporting requirements on the smaller medical practices in the Commonwealth. We will look to clarify how small practices will be impacted by the costs and burdens associated with reporting to new entities established by the legislation. The state must ensure that such efforts avoid duplication and provide a true net benefit to our Commonwealth.
· We are concerned that the bill goes too far expanding the practice prerogatives of some groups of providers. In particular, we find that the favored status granted to limited service clinics to be unwarranted and thinly supported by research or facts. The classification of physician assistants as primary care providers also raises questions. We will monitor these developments closely and will be prepared to advocate for corrective measures if there are unintended consequences.
In an e-mailed statement, Partners HealthCare Chief Executive Gary Gottlieb said the bill offers “a first-in-the-nation approach to health care cost control.”:
It will be a tremendous challenge for hospitals and doctors to reach this target, but Partners is committed to working with our colleagues across the Commonwealth in order to achieve success and make health care more affordable for our patients.
The bill builds on the great strides Massachusetts has made over the past few years as the market developed new products that move away from the old fee-for-service model to one that rewards value and high quality care. As a result, we are starting to see slower growth in health insurance premiums. At Partners, we ripped up contracts with insurance companies in order to give $345 million back to consumers. We have entered into new contract models like the Blue Cross AQC, which holds the promise of continued savings to the marketplace. And, we are one of just 32 organizations in the nation chosen as a ‘Pioneer’ ACO, which can provide a better blueprint for Medicare and ultimately the entire US health system – one that is more cost effective for everyone.
Veronica Turner, executive vice president of 1199SEIU, the state’s largest health care union, sent this statement:
By specifically prioritizing Medicaid rate increases and workforce training in the bill, the legislature is helping to ensure the long term success of these important reforms for the benefit of patients, consumers, and caregivers alike.
The frontline caregivers of 1199SEIU applaud the House and Senate for forging an agreement that gives health care workers a voice in the process moving forward and that also takes steps to protect vulnerable community and safety net hospitals. To help preserve jobs in our state’s highest employment industry, and to help the health care workforce transition to new delivery systems, the legislature has incorporated a workforce training fund into the bill that 1199SEIU members see as a vital component to the success of these reform efforts.
1199SEIU health care workers have been a major presence at the State House during this process and now we are proud to see that the legislature has heeded the input, concerns and voices of frontline caregivers in crafting this final agreement.