mass. health law


Seltz Hired As Director Of New Health Policy Commission

(Updated at 6:10)

A young State House-honed health policy protege will direct Massachusetts’ effort to model health care cost control, WBUR’s Martha Bebinger reports.

David Seltz, age 31, wrote parts of the state’s health care cost control law and will now run the agency assigned to make it work. Seltz has earned the respect of a wide variety of health care leaders, says Rick Lord with Associated Industries of Massachusetts.

“He’s very professional, very balanced in his views and he will work tremendously hard,” Lord said. “That is important as well because of the daunting tasks that face the health policy commission.”

Seltz, who most recently served as Gov. Deval Patrick’s Special Adviser on Health Care Cost Containment, says one of his top priorities will be putting mental health on equal footing with all health care in Massachusetts.

David Seltz, the new executive director of the state's Health Policy Commission

David Seltz, 31, executive director of the state’s new Health Policy Commission

Here’s Martha’s Q and A with Seltz:

MB: Why do you want this job?

I want this job because the work of the commission is critically important to the long term future of Massachusetts. Addressing health care costs while improving quality is one of the great challenges and I believe that the work of this commission is critically important to making that a success.

You were hesitant about taking this position, why?

I have been involved in state government for my entire career working in a number of different policy areas. In reflecting on this opportunity, I wanted to make sure that it was the right one for me and for the board. I was unsure if this was the right fit for myself and for the commission. Ultimately the importance of this work imparted to me that I needed to apply for this job and put myself out there.

What are the things you most want to make sure get done right?

One of the most important things is to approach this position with a sense of collaboration and cooperation with the health care industry. There are a lot of talented and well respected people in the Commonwealth who are working hard on these issues. What I want to accomplish is to bring all that talent into the Health Policy Commission, to tap those resources and be able to leverage all of the abilities of physicians, nurses, providers, industry leaders and advocates to help make the work of the commission a success.

The integration of behavioral health with other medical care is a top priority for this law and for the commission. Integrating mental health services we know can save us money and it’s the right thing to do for patients.

What challenges in the law keep you up at night?

The scope of this law and the work of the commission is daunting. The thing that will keep me up most at night is thinking about the ways we’re encouraging change that will affect patient care, and the opportunity and mandate that we do so in a way that ensures that quality is being improved, that patient access is being maintained and that we are working towards a better health care system for Massachusetts.

Does the pressure of the national spotlight on Massachusetts get to you?

There will be some national attention on everything we do here in Massachusetts. The federal government always looks to us as a test state for these policies. And, because every other state is wrestling with health care costs, they will be looking to see what we do here too. My focus will be on Massachusetts and making this model work and be a success. Success speaks most loudly and working with this board and with this commission, I believe we have the opportunity to do that.

As soon as Seltz was confirmed today, the praise started rolling in.

Here’s a statement from State Senate President Therese Murray’s Office:

“David is the most qualified person to help Massachusetts take this next step forward. He has worked to bring the Commonwealth through a framework of nation-leading health care reforms, including this year’s landmark cost-control legislation. David has proven himself to be an invaluable expert in the areas of health care reform and health care cost and his expertise is recognized on an international level. David has dedicated his entire career to understanding the health care industry and, in this new role, he will continue to guide the industry through these changes to help ensure that we are successful in our cost reduction goals.”

And here’s Lora Pellegrini, President & CEO, Massachusetts Association of Health Plans:

“On behalf of our member health plans, we applaud the Health Policy Commission for naming David Seltz as its first Executive Director. David brings a wealth of knowledge to the position, having been intricately involved in the development of the state’s major health care laws over the last six years in senior positions with Senate President Murray and the Patrick administration. His experience on those issues and familiarity with the state’s health care system make him a terrific choice. “We look forward to working with David and members of the Commission as they proceed to implement the state’s landmark Payment Reform Law to make health care more affordable for Massachusetts employers and working families.”

Bookmark This: New Mass. Site Will Track Health-Cost Law

Gov. Patrick moves from signing to implementing health care costs law (Jesse Costa/WBUR).

All over Massachusetts (and beyond), health policy wonks have spent the last month combing through the state’s new 349 page health care costs and quality law. I’ve seen a dozen different spreadsheets, flowcharts and timelines from people who are trying to figure out how this thing is going to work.

Today the state rolls out a website designed to be a clearinghouse for who is doing what, where, when and why.

“This website provides important information on the law’s implementation in a centralized location and will keep the public updated on the progress we’re making,” says Governor Deval Patrick in the press release announcing the site.

The info is thin so far.  Appointments to the most important board created by the law, the Health Policy Commission, are not expected for a few more weeks.  But this will be the place to track the work of all the boards, commissions, councils and task forces charged with holding down health care costs and improving the quality of care in Massachusetts. Continue reading

News Flash: Doctors, Lawyers Work Together on Med-Mal Reform


It may not seem like big news, but if you’ve followed the long-running, stubborn and mostly dug-in debate over reforming medical malpractice in the U.S., you know that when doctors and lawyers issue a joint news release, something is really going on. (As Carey put it: “Talk about the lions lying down with the lambs!”)

Formally, it’s called “Disclosure, Apology and Offer” and it’s a key provision of the new state health cost law. Massachusetts doctors and lawyers have agreed to work side by side on this less hostile (and potentially cost-saving) approach to dealing with medical errors and malpractice. It essentially boils down to disclosing mistakes, apologizing to the patient and family when appropriate and offering compensation as a way to avoid litigation when possible.

From the Mass. Medical Association, Mass Bar Association and Mass. Academy of Trial Lawyers news release:

An historic and unprecedented partnership between physicians and attorneys in Massachusetts has led to significant reforms to the medical liability system, allowing for improvements to resolving malpractice cases that both sides say could greatly benefit patients by reducing some unnecessary and protracted lawsuits while improving patient safety.

The health care cost control bill recently passed by the Massachusetts legislature and signed by Governor Deval Patrick on August 6 contains specific language that facilitates an approach of Disclosure, Apology, and Offer (DA&O) to address medical malpractice claims.

Representatives from the physicians’ and attorneys’ groups have described their agreement as “unprecedented” and applaud the Legislature and governor for their support of the reforms and including them in the cost control reform bill. Continue reading

As Patrick Signs Health-Cost Law, Critics Weigh In

The market-centric Pioneer Institute is not pleased with the new cost-cutting plan signed into law today by Gov. Deval Patrick. And they’ve designed an infographic to highlight their major complaints.

Pioneer Institute

Joshua Archambault, Pioneer’s health care policy director writes:

As Governor Patrick signs a new healthcare law today aimed at cost containment, expect soaring rhetoric assuring all that Massachusetts has “cracked the code on healthcare costs.” Unfortunately, with no debate on the underlying bill in the House of Representatives and only little debate in the State Senate, the 349-page statute, which was released just 14 hours before the legislative final vote, is little understood and brimming with unintended consequences.

What To Know About Massachusetts’ First-In-Nation Health Cost Law


Massachusetts Governor Deval Patrick, a Democrat and pal of President Obama, hasn’t signed the sweeping, 350-page health care cost-cutting bill yet — but he says he will soon. (Expect a celebratory, bells-and-whistles bash, a la Mitt Romney at Fanueil Hall in 2006, signing health insurance reform legislation that would become a model for Obama’s national health overhaul.)

When the new bill does become law, the Bay state will be the first in the country to attempt to slow rising health care costs through numerous strategies including tethering the growth in health care spending to the state’s overall economy, moving away from fee-for-service payments to doctors and more heavily managing and coordinating medical care.

After the bill passed earlier this week, Representative Steven M. Walsh, a Democrat and House Chair of the Joint Committee on Health Care Financing, who has shepherded the legislation, underscored the consumer’s perspective. “The passage of today’s bill is all about seeing our health care system through the eyes of the patient. We have the highest quality medical system in the nation and the highest percentage of health care coverage, yet it is a struggle for families to afford their health insurance premiums. This legislation focuses on increasing efficiency and cutting costs within our system, while enhancing the quality of care that our patients receive and empowering them to make the best personal health decisions.”

Even if you don’t live in Massachusetts, many of these changes — in some form or another — will likely be coming to your state or doctor’s office too. We’re still digesting all the details and implications. But here’s an early snapshot of five things you might like to know:

1. Try Not To Get Sick In The First Place

Prevention and wellness are a priority in the new Massachusetts cost-cutting plan. If you lead a healthy lifestyle and try to care for your body through diet, exercise, not smoking, good attitude (when possible) etc. you can spend more time away from the doctor and out of the hospital thus saving the system money and just generally making life better. Under the Mass. plan, there’s $60 million for a prevention and wellness trust fund to boost such efforts. There are also tax credits for small businesses that run wellness programs.

2. The Cost Of Care

Speaking of budgeting, there will now be even greater pressure on your doctor, hospital or hospital system to save money. That means you will have to start thinking much more about how much your health care costs. Under the Mass. plan, hospitals and doctors will have to cut their rate of growth by about half. You, as the patient, may experience this in various ways, for instance, fewer non-critical tests, procedures and imaging Continue reading

Landmark Health Care Cost-Cutting Plan Sent To Governor, Set To Become Law

This just in: a joint House-Senate press release on the passage of a sweeping, first-in-the-nation health care payment reform plan, now on it’s way to the governor’s desk:

BOSTON – The Legislature today completed work on a framework of nation-leading health care reforms, sending to the Governor a comprehensive, landmark cost-control bill estimated to save the Commonwealth $200 billion over the next 15 years while improving the quality of care, increasing patient access, and strengthening the transparency and accountability of the state’s entire health care system.

The bill comes at a crucial time as health spending is projected to double from 2009 to 2020, outpacing both inflation and growth in the overall economy, while Massachusetts residents and businesses continue to struggle with increasing premiums and other health care costs. Continue reading

Analysis: Misconstrued Conclusions On State Health Law Costs


The great thing about blogging is that you can fix stuff really fast.

So here goes:

Yesterday we linked to a story in The Boston Herald about a report on state health reform by researchers at Yale and The Wharton School.

Today I got email from Jeff-Levin Scherz, who blogs on Managing Health Care Costs, setting the record straight. He writes: “The Herald article on the Wharton/Yale research on MA health care reform that you highlighted yesterday totally misconstrued the conclusions.”

Here’s his post in its entirety:

Here’s the first paragraph of an article from the Boston Herald abstracted by CommonHealth yesterday:

“The nation’s anemic economic recovery could suffer a brutal blow at the hands of Obamacare, critics say, as a new study shows mandated health care in Massachusetts cut $6,000 from some Bay State residents’ annual pay.”

Here’s the conclusion from the actual paper.

“Our results suggest that mandate-based reform has the potential to be a very efficient approach
for expanding health insurance coverage nationally.”

The same researchers previously reported that health care reform in Massachusetts decreased the number of uninsured, and: Continue reading