Why Massachusetts is the state to lead reform, cost control

Massachusetts implemented its own universal health plan six years ago and today more than 98 percent of residents are insured. Yet the industry still questions whether to follow the Bay State's lead for improving access and controlling costs.

"We are on track to crack the code on cost control," Massachusetts Gov. Deval Patrick wrote yesterday in a Kaiser Health News column. He cited scrutinizing excessive insurance premiums and standardizing codes and forms for insurers and providers to eliminate duplicative efforts.

Patrick also encouraged the industry follow Massachusetts as it embraces global payments, which he included in his healthcare cost-containment legislation last week, reported Kaiser Health News. He expects the state legislature to pass the payment reform bill, which also promotes integrated, accountable care, by this summer.

However, a June 2011 report from the Massachusetts Attorney General found that the state's globally paid providers didn't have less medical expenses than doctors paid the standard way, and some large doctor groups were far more expensive than physicians paid under the traditional fee-for-service system, FierceHealthPayer previously reported.

But with the highest level of healthcare coverage nationwide and three consecutive years of shrinking hospital expenditures, the Massachusetts Hospital Association (MHA) said the state is on the right course for success, according to another Kaiser Health News column. Yet collaboration and balance will be needed to maintain adequate access to services and lower healthcare spending, it noted.

"You can't target just one participant in the system and hope to achieve sustainable success," wrote MHA President and CEO Lynn Nicholas. "Government should lead the way and set a goal to lower total health care spending by a reasonable amount in a reasonable time frame. That will motivate everyone to get involved, find solutions and achieve success."

For more:
- read the KHN article
- check out Patrick's column and Nicholas' column

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