"Don't Give Up the Ship" by Dolores L. Mitchell

The budget ax fell, last week, on the Quality and Cost Council — the other half of Ch. 58’s Health Care Reform Law. Charged with creating a web-site to provide consumers with comparative price and quality information, and led by a board consisting of an admixture of state health care agency heads, A and F, the Inspector General, representatives of the Attorney General and the Auditor, prominent providers, payers health policy experts, and buyers, and the Council has taken significant steps toward addressing its mandate. This, despite a bare bones budget and a minimalist staff, augmented by staff from DHCFP and others. The complex claims data operation authorized by Ch. 58 did take place, a web site developer did put together the web site structure, consultants have vetted the statistical booby traps involved in presenting data, and a contractor has been selected to map out how the Council and the Commonwealth might use all these data to begin to deal with ever-rising costs. And then came the budget crunch. Making cuts in program is never easy and critics can say that cost cutting strategies should have been the last thing cut, not the first. And for the staff who are losing their jobs, it is probably cold comfort that they go, with the respect and gratitude of the council members who know how hard they have worked and how far they have come. But the need to do something about rising costs does not go away with their departure,

and Council members would do well, not to drop their involvement, but rather, to increase it — to use the Council coordinator to keep them apprised of the progress on the web site, on how DHCFP and DPH are pursuing the development of the cost control plan, and a strategy on how he or she can work with the Council to fulfill the mission. The Council does not have operational powers or responsibilities. Its mission is to set goals, provide transparency, recommend strategy, monitor progress and publicize the results. These tasks are difficult even with dedicated staff. With just one coordinator, they are even harder, and monitoring progress will mean keeping tabs on how successfully DHCFP and DPH are picking up the responsibilities formerly performed by the staff that is leaving. It probably means more work by the Council members themselves. But it can be done if there is a will to work together to make the Council meaningful. With a Council determined to keep their eyes on the prize, the mission need not be scrapped

Dolores L. Mitchell, Executive Director of the Group Insurance Commission of the Commonwealth of Massachusetts, the agency that provides life, health, disability and dental and vision services to over 285,000 State employees, retirees and their dependents.