In a virtual hearing on Wednesday, the commissioner said he wasn’t interested in bankrupting the healthcare system by curbing spending growth, and as the industry worked on a pandemic, spending far exceeded the 2021 and 2022 benchmarks of 3.1%. He admitted that it could grow beyond that. Still, the commissioner said the system needed constraints.
“On the other hand, we can’t brake and we need to continue to slow spending growth in order to have an affordable healthcare system for all citizens,” said Stuart Altman, chairman. increase. Of the committee. “But we also can’t forget these streams that aren’t normal in any range of imagination, and we don’t want to shorten our health system to deal with these problems.”
Since 2013, this benchmark has been used by the Commission to investigate high medical costs by market participants and is one of the key mechanisms used by the state to lock in rising medical costs. According to state law, 2023 was the first year of the Commission, and the legislature was able to benchmark at any rate they chose.
Benchmarks do not always meet the state’s own goals, but help the state fall below the national growth rate of total health care costs since 2013. According to a presentation on Wednesday, health care costs increased 3.6% in 2018 and 4.1% in 2019, surpassing the state’s 3.1% benchmark.
The pandemic has reduced health care costs for the first time since the state began tracking numbers, down 2.4% in 2020, the latest year for which data are available.
Record inflation and rising labor costs have warned hospital groups that medical costs could rise.
Providers and payers that exceed state standards are at risk of penalties by the Commission and are forced to develop state-approved plans to curb spending or face fines.
Commissioner David Cutler said that in the event of a pandemic, the Commission must be flexible in how benchmarks are applied to providers and payers. However, organizations that traditionally had significantly higher spending and higher costs are less tolerant of higher spending.
The Massachusetts Association of Health Plans, which represents the 15 largest insurance companies except BlueCrossBlueShield in Massachusetts, said it was a check on health care costs and praised the benchmark rate.
Lora Pellegrini, CEO of the Massachusetts Health Planning Association, said:
In a statement, Steve Walsh, CEO of the Massachusetts Health Hospital Association, said the benchmark needed reform.
“Our medical institutions are still operating under unusual circumstances,” Walsh said. “This reality needs to be at the forefront whenever we evaluate system performance or make decisions that affect how hospitals operate. MHA and its members benchmark cost growth. We make it clear that we have strong support, but it is an important tool that is in great need of evolution. “
The Commission also said it was paying attention to integration and partnerships as the state continued to focus on curbing health care costs. Most notably, the Commission said it was considering some of the plans for the Boston Children’s Hospital.
The hospital’s parent company is proposing the acquisition of Francis Can Childrens, a specialized children’s hospital that requires committee review.Commission staff said they had already begun the analysis Boston Children’s proposed a $ 435 million outpatient expansion to three suburban communities. At the same time, the Commission was paying attention to plans to close 41 pediatric hospital beds at Tufts Medical Center and transfer care to Boston Children. Staff said this could cause HPC monitoring.
“What we’re ultimately getting is a huge integration of all children’s healthcare in the Commonwealth under Boston Children,” Altman said. “And there are significant cost and spending implications that we need to consider. [at] … I think we’ll be seriously discussing this in the coming weeks and months. “
You can contact Jessica Bartlett at jessica.bartlett@globe.com. Follow her on her Twitter @ByJessBartlett..
