Will a legislative study put Massachusetts on the path to single-payer? Supporters head to Beacon Hill to push for it.

single payer posterTucked inside the health care bill passed by the state Senate is a provision to study the possibility of a  single-payer health care system.

The bill’s cost control measures are getting all the attention. From the Globe:  

The 100-page bill attempts to help struggling community hospitals by setting a floor for the reimbursements they receive from insurers. It also sets a benchmark for annual growth in hospital spending, estimated at 2.7 percent. If the hospital industry exceeds that benchmark, some hospitals would have to pay hefty penalties.

But MassCare, the state’s single-payer advocacy group, says the proposed study creates “a real path in the near future to create a Single Payer system for the Commonwealth!” They’re headed up to the State House this week to lobby House members. lobbyday-958x538

These folks are in if for the long haul, which, according to political scientist James Munroe of Brown University,  is the way to go on single-payer. Writing in the a recent NEMJ, he says:

It is a policy proposal designed to improve health care delivery, an ambitious claim about equality and social justice, and an effort to usher in a more progressive era in American politics. Each is a long shot, but Medicare for All and its advocates stand in a venerable reform tradition that has rewritten U.S. politics many times in the past. It would be a mistake to dismiss them now.


Health Policy Commission versus Partners

Lots of amazing research and care happens at Partners Healthcare, and we pay a bonus for it.

Or, as  Boston Globe writer   puts it “Partners has long been criticized for using its power in the health care market to extract higher payments from insurers and driving up health care costs.”

But, Partners faces scrutiny from the Massachusetts Health Policy Commission, a panel that includes some health care heavyweights and a team of data analysts who are tracking cost and utilization in the state.  

McCluskey reports in today’s paper: 

Partners HealthCare’s expansion plans suffered a setback Wednesday after a state watchdog agency warned that health care costs for consumers would rise significantly if Partners is allowed to acquire the specialty hospital Massachusetts Eye and Ear.

The Health Policy Commission said Partners, the state’s largest health care network, is likely to seek higher reimbursements for care by Mass. Eye and Ear and its doctors if the deal goes through. Because Partners is already a high-priced network, the deal would increase health care spending statewide by $20.8 million to $61.2 million a year, according to the commission.

“These spending increases would ultimately be borne by consumers and businesses through higher commercial premiums,” the commission said in a lengthy report.

Last year, your correspondent interviewed Brandies economist Stuart Altman, who chairs the panel, about what Massachusetts is doing to contain health costs.

First of all, it is the only state that has recognized that it should be involved in total state spending. Some other states that are closer are Vermont and Maryland. But the Massachusetts state government is really acknowledging that it has responsibility for not only what it spends on Medicaid, but that it should be concerned with total spending.


Can hospitals be leaner?@STATnews take you insides the Brigham’s “struggle to cut costs.”

More here.

Over the past three months, the Brigham provided STAT unbrigham

usual access to meetings of its top management and internal deliberations and documents. 

This inside look shows how one of the nation’s leading hospitals is confronting the daunting financial and marketplace forces buffeting academic medical centers across the U.S.

“This wasn’t about ordinary cost-cutting,” Walls said. “It was very clear we had to become a much leaner, more efficient organization.”


All eyes should be on Massachusetts (again) as the state moves beyond expanding coverage to tackling health costs.

The Massachusetts Health Policy Commission is an organization that my peers at the Health Wonk Review can get excited about But the public should too. In health care, smaller cost increases are considered a victory. All of the testimony from hospitals and other healthcare players for an October 3/4 hearing on cost trends is already posted online   

Here’s what chair Stewart Altman writes about their latest report. altman book

“The CHIA report shows positive news for the Commonwealth, chiefly, health care spending increased 2.8% between 2015 and 2016, well below the 3.6% benchmark set by the HPC. Since the establishment of the HPC five years ago, the state, on average, has been below the cost growth benchmark as set forth in law, and lower than national growth trends.

“However, even with these positive trends, there continue to be areas of concern – and challenges ahead. Overall affordability remains an issue for our residents, businesses, and the state. The HPC is anxious to dive deeper into the data and the policy issues they raise at our upcoming Health Care Cost Trends Hearing on October 2 and 3. Through this and other public forums, and our ongoing policy development and programs, the HPC will continue to push the industry to find solutions to create a more transparent, accountable, and affordable health care system on behalf of consumers and businesses in Massachusetts.”


Social determinants of health, data dominate Boston event hosted by Atlantic magazine

From Health Leaders Media

The small crowd at Tuesday’s “On the Front Lines of Healthcare” event in Boston included a patient activist, a state health systems analyst, and even a doctor who was in town for a gastroenterologist meeting.


But the gathering, held in an airy space on 33rd floor of a downtown 


high rise, was not a professional or academic m


eeting. Organized by The Atlantic and the STAT, a national science and medicine publication, the public event offered an ambitious overview of a range of weighty issues.

Three big topics that resonated throughout the day: the social determinants of health, data, and machine learning—computers that can digest data and use it to answer questions about patient care.



#Social determinants of health is a mouthful, but the concept could be key to population #wellness

logoMore on former Denver Health DEO Patty Gabow Lown keynote from HLM. 

First, don’t expect Congress to save the system. Instead, Gabow proposed a to-do list for health systems that is heavy on improving the social determinants that affect health, but also places a high value on such ideas as a living wage for all employees.

Gabow said she made similar changes in Denver, delivered high quality care, and saved her system money. 

“You may wonder, after hearing that I spend 40 years at a healthcare institution, why I would pose a question like this: Can American healthcare deliver health? “she said.

“It is precisely because I spent 40 years at a safety-net institution that took fabulous care of patients. I saw every day that our patient had barriers to well- being and health.

#Lown2017 activists are meeting to talk about appropriate care and why our health system can’t deliver it.

img_0252One of the sessions at Saturday’s Lown Institute annual conference was entitled “Corruption and Patient Harm in the Medical Industrial Complex.” Today, members are meeting to develop a strategy to challenge all that. (More on their case in The Lancet,)

Keynotes at the meeting outside Boston included global economist Jeffrey Sachs — who spoke the day after the House vote on the ACA. In his remarks, as reported on Twitter,  Sachs ripped the profit-driven health care delivery system. Other speakers included journalist Elizabeth Rosenthal and UNC AIDS doc Charlie van der Horst, a leader in NC’s Moral Mondays movement.

Click here or search #Lown2017 for small sample of conference social media.