PUBLIC HEARINGS WILL IDENTIFY COST DRIVERS by Bruce Bullen

As we move into our third year of health reform, Massachusetts has surpassed expectations when it comes to covering the uninsured. At the same time, Massachusetts tops the nation in overall health care spending per capita, and our medical trend far exceeds the national average. We will not be successful long-term unless we begin to control health care spending. Thanks to the leadership of Senate President Murray, we have an opportunity for a serious conversation about cost control. Senate President Murray’s bill offers a multi-pronged approach to controlling costs and improving the effectiveness of our health care system. Her bill contains many good ideas, and I applaud her efforts.

The conversation about controlling costs must begin with greater public disclosure of health care cost and quality information. Public hearings involving both insurers and providers can and should serve as the forum to provide this information.

For a number of reasons, the Massachusetts Association of Health Plans and Harvard Pilgrim believe that the Health Care Quality and Cost Council should conduct these public hearings.

First, the Council has broad stakeholder representation – including the Commissioner of Insurance, the Secretary of Health and Human Services and the Attorney General, who oversees public charities. Second, the Council is already playing a central role in the transparency discussion, with the posting of comparative cost and quality information online. Finally, and most importantly, the fact that close to 90% of health insurance premiums are used by insurers to pay health care providers means that the conversation about what’s driving premium increases is inextricably linked to the conversation about what’s driving provider costs, making it important for the public to hear from both insurers and providers in the same forum. After hearing from both, the Council would be well positioned to provide the public and policy makers with a complete picture of the problem of rising costs and a set of well-reasoned recommendations on what we should do about it.

We have an important opportunity to move the cost control agenda forward in a meaningful and public way. We should structure the conversation to be as effective as possible.

Bruce Bullen,
Chief Operating Officer, Harvard Pilgrim Health Care