State health care costs a hot topic at Salem meeting

SALEM – Health-care providers told members of the Joint Committee on Health Care Financing that the cost-saving goal of Gov. Deval Patrick’s bill to promote “accountable care organizations” that encourage alternatives to a fee-for-service payment for health care is a step in the right direction.But they also urged collaboration among legislators, physicians and health-care providers to address questions about how the proposal would maintain quality care.”The accountable care organizations are not a huge change, but it needs to be pursued carefully,” said Health and Human Services Commissioner Barbara Leadholm.But she nevertheless urged that something be done, and done quickly, to control health-care costs.”I think our belief is that the sooner you can hit the ground running and see some success, the harder it is to go back to an old regime and method (of payment). We’re under the gun to do something.”The health care financing committee met in Salem on Monday for its second of four planned regional hearings on House Bill 1849.The bill is Patrick’s effort to control rising health-care costs by moving from a fee-for-service payment method, where health care providers are paid for the services they provide and thus have the incentive to order expensive treatments, to a global payment system where providers are encouraged to control costs because they are paid only a set amount.Dolores Mitchell, executive director of the Group Insurance Commission, which provides health insurance for municipal employees throughout the state, said the main feature of the bill is that it replaces “inevitably inflationary” fee-for-services methods of payment with accountable care organizations (ACOs).These organizations consist of groups of service providers that offer coordinated and less-expensive preventative health services, which she said gives incentives for health care planning, but “most importantly puts doctors and patients front and center.”But the committee Co-Chair, state Rep. Steven Walsh, D-Lynn, said he was not sure whether these organizations were the best method for controlling costs.Much of the discussion among committee members and testimony discussed several questions that needed to be addressed.Former state Rep. Mary Grant, who testified representing Mass Home Care, noted that the bill does not deal with long-term care or care for chronic conditions, which contribute to the high costs in the health-care systems.John Hurst, representing the Retailers Association of Massachusetts, noted that the bill does not yet address the disparities in premiums paid by small businesses who are “self-insurers.”Christine Sullivan, the chief executive of the Enterprise Center at Salem State University, testified that health-care costs for small businesses have prevented increased hiring and the economic recovery.After the hearing, Walsh said that the hearing was helpful in determining the issues that needed to be addressed in the governor’s proposal, or competing plans offered by legislators.”The reason we’re doing these regional hearings is to see how (the proposed bill) affects people and make sure that the changes aren’t detrimental,” explained Walsh.