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Lawmakers Betting On Gambling To Help Fund Health Reform


This just in: How might casinos help Massachusetts tamp down rising health care costs? WBUR’s Martha Bebinger reports:

Twenty-three percent of the money the state receives from casino and slot parlor licensing fees would go into a new Healthcare Payment Reform Fund.

Supporters of the fund, which is in both the House and Senate casino bills, hope to raise $40 to 50 million for the move to electronic health records and for other costs they say will eventually help the state spend less on health care.

The health care fund would get the largest single share of casino license fees with the balance going to community colleges, transportation, community mitigation and other projects. The House and Senate are still working on major legislation they hope will lead the state to better, more efficient and lower cost health care. But they are betting that some of the money they need will come from casino developers.

Legislative leaders aren’t sure exactly what the fund would be used for — it could also pay to retrain health care workers whose jobs change as the state overhauls health care spending.

The Senate had hoped to release its health care payment reform bill next month, but that schedule looks doubtful now. For letter-of-the-law types, here’s the relevant section of the bill: Continue reading

Unanimous Committee Thumbs Up For Primary Care Bill

Rep. Jeffrey Sanchez

This just in from the office of Rep. Jeffrey Sanchez, co-chair of the committee:

BOSTON—The Joint Committee on Public Health voted unanimously in favor of “An act supporting the practice of primary care in the commonwealth.” Sponsored by Representative Jeffrey Sánchez, co-chair of the Committee, the bill eases statutory burdens to maximize the role of physician assistants and nurse practitioners in order to improve access to care for patients and free up physicians’ time for complicated cases requiring their expertise.

“While Massachusetts’ 2006 health reform made incredible gains in coverage, further work is required to transform the health care workforce into a more team-based approach to primary care,” Sánchez said. “As the Commonwealth moves forward in payment reform, it is crucial that we have a strong primary care workforce that can ensure all our residents are healthy and have access to quality care.”

In the context of payment reform, the Rand Report to the Special Commission on the Health Care Payment System projected savings up to $8.4 billion over 10 years if we enhanced patient care through increased utilization of nurse practitioners and physician assistants.

Increasing the number of primary care practitioners requires a multi-faceted approach. The bill reported out of Committee was amended to include a special commission on family physicians and other primary care physicians in community care settings.

As Rachel wrote here in April, the Massachusetts Medical Society opposed several bills this session that sought to enhance the status of non-physician providers, from nurse midwives to physicians assistants, arguing that they could endanger patients. (Jeff Sanchez’s response to their opposition is here.)

On other bills, from the public health committee:

The Committee also favorably reported bills relating to the scope of practice of optometrists and podiatrists, allowing for these providers to treat more conditions within the scope of their education and training, increasing access to these services.
Other bills reported favorably include An Act to eliminate racial and ethnic health disparities in the Commonwealth, An Act to establish community based grant programs to eliminate racial and ethnic health disparities in the Commonwealth and An Act to increase routine screening for HIV.

Timetable For Health Reform Bill? ‘Maybe 70% Chance By Year’s End’

The scene: A packed forum yesterday at Suffolk University’s Modern Theatre, the old Theatre District movie house once considered beyond repair, now miraculously refurbished, a charming public space once again.

The cast, brought together by CommonWealth magazine and MassINC: Star-studded, at least for our local health care world. Recent Republican gubernatorial candidate Charlie Baker. Health and Human Services secretary JudyAnn Bigby. Blue Cross Blue Shield chief Andrew Dreyfus. Outgoing Tufts Medical Center chief Ellen Zane. And representing the representatives, Ron Mariano, majority leader of the Massachusetts House.

Cutting to the chase: After more than an hour of cogent but somewhat insider-ish debate about global payments and the coming phase of health care reform in Massachusetts, an audience member asked the most newsworthy question: What kind of timetable can we expect from the legislature? (Lawmakers would need to approve any proposed reform.)

There followed a few seconds of pained laughter, which I read to mean, “Yeah, good luck predicting what the legislature will do.” Then this, from Rep. Mariano:

In case you can’t make out his basso profundo, here’s the best I can do:

Putting on my best Las Vegas hat….(more pained laughter) There’s an understanding that we have to do something and I think that we’re looking very closely at the governor’s bill. We have a new chairman of health care…and he’s going to have some recommendations and I’m hopeful that we will begin to have hearings probably in the fall and maybe, by the end of the year there’s a 70% chance we could get something. But I think at least by next spring we will have either a version of the governor’s bill, if we’re ready to endorse it, or debate the senate as they do whatever they’re doing…

But I think it’s very likely we’ll have something — I think it’s 70% this year, and if not we’ll get into next year. But there is an understanding — the speaker has said publicly that he wants to do something. I think he understands that it’s an issue we have to address head on in some way….The one thing that I’ll say about this is if this doesn’t work, it’ll change very quickly because the groundswell, the patient revolt was so strong.

Health Costs Are ‘1st, 2nd And 3rd’ Legislative Priority, Mass. Business Group Says

AIM's John Regan


Colleen Quinn of the State House News Service reports from AIM’s State House visit yesterday:

BOSTON – Containing health care costs will make Massachusetts employers more likely to hire more people and help the state grow its tax base, representatives from the state’s largest business group said Wednesday. Associated Industries of Massachusetts officials said high all-around business costs in Massachusetts, and competition from other states, make health care cost control the group’s first, second and third legislative priority for the new two-year session.

The news service quoted AIM executive vice president John Regan:
“I jokingly say to people, and only half jokingly, that in terms of the agenda for 2011-2012, it is pretty easy to state,” Regan said. “Health care cost containment is number one, followed by health care cost containment, and then health care cost containment. Then there are probably a couple of other things we will work on as well.”

AIM is backing 21 bills for this legislative session, State House News reports, among them:

Sen. Michael Moore (D-Millbury) is sponsoring a bill backed by AIM that imposes a moratorium on new insurance mandates and adjusts the amount of deductibles and co-payments allowed under minimum creditable coverage to keep pace with inflation.
The bill also would eliminate the medical security trust fund and the assessment that employers must pay every year to fund this program to provide health insurance to the unemployed or uninsured, according to AIM. The bill calls for the state to use its existing programs to insure those covered under the fund.
Another bill, sponsored by House Minority Leader Brad Jones, would give municipalities more flexibility in offering health insurance to employees. Legislators are under pressure to curb municipal health care costs, with public employee unions resisting changes that could erode collective bargaining rights.
A third bill, sponsored by Rep. Harriet Stanley (D-West Newbury) would require Medicaid patients to enroll in managed care programs to coordinate their care – a proposal the Legislature has repeatedly rejected – and also would ask Medicaid officials to conduct a pilot program on payment reform.