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Mass. Health Plans Report: Payment Reform Won’t Fix Prices

Two charts: " Globally Paid Providers Do Not Have Consistently Lower  Total Medical Expense" and "Price Increases Caused the Majority of the Increases in  Health Care Costs in the Last Six Years" (2011 Annual Report of the Massachusetts Association of Health Plans)

From the 2011 Annual Report of the Massachusetts Association of Health Plans.

The latest Massachusetts Association of Health Plans annual report is out, and it offers some very colorful visual reminders of a point many in the state have been making: To stem the growth in health care costs, payment reform is not enough; something must be done about the “market distortion” that allows some hospitals to charge far higher prices than others.

As illustrated in the chart above, in which the hospitals with yellow circles next to them have long been part of payment-reform-type plans yet remain relatively expensive, “Changing the way we pay is just not enough,” association president Lora M. Pellegrini said.

“You have to address the market power issues and the price distortion issues,” she said. “Legislation that deals with payment reform issues only and that doesn’t address market distortion issues is not going to fix our cost problem.”

The report includes comments from three state leaders — Attorney General Martha Coakley, House majority leader Ronald Mariano, and Administration and Finance Secretary Jay Gonzalez — on possible solutions. You can download the whole document here.

Pennsylvania Slashes State Health Insurance, In Contrast To Mass.

Tom and Paula Michele Boyle, Pennsylvania residents who are about to lose their state-funded insurance


File under “Reasons to be glad we live in Massachusetts.”

NPR reports today that Pennsylvania’s entire state-funded health insurance program for low-income adults is about to be cut, leaving 42,000 members uninsured. Nearly 500,000 people had been on the waiting list, hoping to join the program.

States around the country are facing similar cuts in this season of exploding budget crises. In California, Gov. Jerry Brown is proposing to slash more than a billion-dollar swath out of state health programs, as reported here.

Not here in Massachusetts. As WBUR’s Martha Bebinger reported earlier this month:

In a tough budget year, the Patrick administration is out with a strategy to maintain subsidized coverage for 174,000 low to moderate income residents. While states around the country are trimming government health insurance, Secretary for Administration and Finance Jay Gonzalez says Massachusetts will preserve near universal coverage. Continue reading