Union pushes for hospital price regulation in Massachusetts

A labor-based ballot initiative could cap hospital prices in Massachusetts if approved by voters, Commonwealth Magazine has reported.

The initiative, which was introduced by a Massachusetts chapter of the Service Employees International Union, would mandate any health insurer doing business in the state would have to limit reimbursements to providers to no more than 20 percent above or 10 percent below "the carrier-specific average relative price for that service." Any net savings to insurers would also have to be rebated to enrollees in the form of lower premiums, deductibles or co-payments.

Healthcare costs in Massachusetts are among the highest in the nation, as much as 55 percent higher than the nationwide average in 2010. And despite mandating a high level of price transparency, surveys indicate many patients still have troubles obtaining accurate costs for the care they receive.

The intent of the ballot initiative is to try and right the current balance in the Bay State toward the hospitals operated by Partners HealthCare System. Partners' market clout means it collects 28 cents of every dollar spent on healthcare services in Massachusetts. And other studies have linked higher prices among Massachusetts providers to greater intake of revenue.

SEIU data ctied by Commonwealth indicates that such a redistribution of payments would cost Partners some $439.8 million in reimbursements from private insurers. South Shore Hospital would lose another $16.8 million. By comparison, nine other hospitals would receive increased payments totaling $139.6 million.

Hospitals have expressed their objections to the measure, and Partners is expected to fight it tooth and nail if it does reach the November ballot. But the article has suggested it may be a ploy to get lawmakers to address the price disparity issue directly.

To learn more:
- read the Commonwealth magazine article

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