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This is the bullet point version of Senate President Therese Murray's cost containment she outlined it at a State House committee hearing today. Are there any particular areas you would like to hear more about?

• Across the United States, premium increases have been between six and seven percent on average. Massachusetts, however, has seen double-digit increases for the last eight years. We need to find out why this is happening here and nowhere else.

• This growth in health care costs is out-pacing the increase in workers’ wages (3.7 percent) and the overall inflation rate (2.6 percent).

• That’s why we propose to hold public hearings for any insurance company that submits premium increases above 7 percent.

• These reviews will explore administrative costs, marketing costs, salaries, compensation packages and reserves.

• We also propose public hearings with health care providers to investigate cost-drivers and make cost-reduction recommendations.

• In short, we need more transparency if we expect to maintain the integrity of our health care system.

• This brings me to an issue that has been getting a lot of attention since we announced the second phase of health care reform….

• The proposed gift ban.

• Let me be clear: No one is proposing to ban the efforts of pharmaceutical companies to educate doctors and nurses about new medical drugs.

• What we want to avoid is the perception of any influence that could lead to the unnecessary or improper marketing, prescription or use of a drug. (Oxycontin example)

• Education is important, but if we’re going to call for transparency, then everyone must be accountable.

• In addition to transparency, another major cost hindrance to our health care system is the failure to implement information technology systems.• The Senate legislation requires statewide adoption of electronic health records by the year 2015, supported by $25 million a year from the proposed cigarette tax increase.

• We also propose a deadline of 2012 for statewide adoption of computerized physician order entry systems (CPOE).

• Updating these systems could save us hundreds of millions of dollars while also reducing the occurrence of medical errors.

• The Massachusetts Technology Collaborative says the statewide adoption of CPOE alone could save us $170 million a year and prevent 55,000 adverse drug events annually that result in patient injury or death.

• Uniform billing and coding – something Senator Spilka has worked very hard on – is another area where technology can save money. The current system for documenting services and processing claims is antiquated.• Our proposed legislation sets a statewide standard for uniform billing and coding among health care providers and insurance companies to reduce administrative costs and promote significant savings.


• I would also like to bring more attention to the Determination Of Need process, which is addressed in the bill.

• The duplication of services and expensive technologies is a hindrance to the efficient use of health care resources and a major contributor to overall health care costs.

• Finally, we need to improve access to primary care. This is an essential part of the health care equation.

• The initial success of health care reform has brought people into the system much faster than we anticipated.

• There are now 300,000 newly-insured individuals, which means half of the Commonwealth’s uninsured are now in the system since health care reform began just two years ago.

• That’s an amazing accomplishment, but the shortage of primary care providers that existed even before the first phase of health care reform has created a real challenge.

• A recent physician office poll shows it is significantly more difficult to obtain a primary care appointment now than it was a year ago.

• Just half (51%) of all internists are accepting new patients, down from 64% in 2006 and 66% in 2005.

• The average wait time among internal medicine physicians accepting new patients is up to 52 days.

• The longer patients wait and conditions go untreated, the more likely they are to resort to expensive emergency room visits. This shouldn’t be the case.

• Re-establishing access to primary care is essential for managing illnesses efficiently.

• In order to address this problem, we propose to increase primary care access through various measures:
• First, we will establish a new Primary Care Recruitment Center to coordinate statewide primary care workforce activities;

• Second, we will expand enrollment at UMass Medical School for students committed to primary care;

• Third, we will authorize loan forgiveness programs and an Enhanced Learning Contract for UMass medical students who commit to providing primary care in the Commonwealth – Retaining the doctors we train is important since each year slightly more than half of our medical residents pursue the next step of their careers outside of Massachusetts.

• And, fourth, we will expand the role of nurse practitioners as primary care providers, and increase the number of physician assistants per doctor from two to four.

• Furthermore, by expanding the role of primary care providers into the “medical home” model for patients, we will expect to see better management of chronic illnesses, fewer hospitalizations and improved overall health.

This program aired on March 12, 2008. The audio for this program is not available.