Hearing Draws Crowd to Debate Payment Reform

WBUR's Sacha Pfeiffer attended the legislature's first public hearing on revamping the way doctors and hospitals are paid in Massachusetts. Here's a brief report:

Several leaders of the state's health care reform effort testified today at a hearing before the joint commission on health care financing, chaired by Sen. Richard Moore, urging legislators to reform the medical payment process in Massachusetts as quickly as possible. Many of them voiced support for a proposal, made earlier this year by a state commission on payment reform, to radically change how insurers pay doctors and hospitals.

Called "global payments," the plan would set a fixed payment for each patient that would cover all of that patient's care for a whole year. The commission recommended that global payments replace the current system, in which doctors receive a fee for every service they provide — an approach that critics say drives up health care costs unnecessarily by providing a financial incentive to do more.

Citing "unsupportable premium increases" and rapidly rising health care costs, Dolores Mitchell, executive director of the state's Group Insurance Commission, cautioned that "we don't have time to waste." Her concerns were echoed by Dr. Mario Motta, president of the Massachusetts Medical Society, who warned that health care costs in the state have "become unaffordable and unsustainable."

Rick Lopez, Chief Physician Executive of Atrius Health, a strong proponent of reform, testified that "global payments are not a radical new idea but rather a revival of the best of managed care combined with the many lessons we learned back in the 1980’s and 1990’s."

The commission that recommended shifting to a statewide "global payments" system has suggested phasing in the new approach over five years. Massachusetts Secretary of Administration and Finance Leslie Kirwan, who leaves her post tomorrow for a new job at Harvard University, said she considers the five-year plan reasonable but the transition must be "careful and structured" to keep disruption to a minimum.

For more on the hearings, read the State House News Service story here. For those with extraordinary stamina, CommonHealth expects to post video of the entire hearing when it becomes available.