price disparities


Coakley Calls For Patient Cost Estimates, ‘Clout’ Limit, Possible 2015 Caps

Attorney General Martha Coakley

Massachusetts Attorney General Martha Coakley broaches three new tactics — or “pillars,” as she puts it — for containing the state’s health costs in her speech today to the Massachusetts Association of Health Plans. A long swath of the prepared text follows, but here are three key quotes:

•”We are considering requirements that providers disclose the full amount that consumers could be liable to pay, so that patients know in advance what they are agreeing to.”

•”When a provider does reach a certain level of market clout, it should trigger a market impact review to determine whether the provider’s size is having a negative impact on consumer choice, access, or healthy market function.”

•”Starting in 2015, if the market has not corrected unwarranted price variation, the administration should be able to reject health plan contracts with excessive or inadequate provider price variations. Health plans should be prohibited from paying provider rates that differ beyond a certain band. One example would be 20% above or 20% below the plan’s average price for the previous year. Any savings would then be directed to consumers in the form of lower premiums. Finally, I believe we should make this market intervention temporary.”

WBUR’s Martha Bebinger is at the MAHP conference and will be gathering reaction. Please stay tuned, and your opinions are deeply welcome in the comments below. Now for the text, with deep thanks to the Coakley staff for the camera-ready copy: Continue reading