Cornucopia Of Reactions To AG's Report On Health Care Costs

Attorney General Martha Coakley
Attorney General Martha Coakley

It's hard to imagine anybody saying, "No! I want health care costs to keep going up!" But the Herald story did reap the usual bounty of choleric comments like this one:

Sure, put me on a budget for health care....hmmmm install a stent? nope not this year, guess I'll have to save up and not get sick for a couple of years... or DIE first!

Asked about the report today, Gov. Deval Patrick emphasized the common ground it occupies with his own plans for health care reform. He too, he said, has been concerned that the next phase of reform not set into stone the price differences among different health care providers.

Blue Cross Blue Shield of Massachusetts issued a statement both commending the attorney general and defending its global payment plan, which the report found had failed to save money.

In its findings, the report states that a “shift of payment methodology by itself is not the panacea to controlling costs.” We agree. Also important are the adoption of new value-based benefit plans noted above along with a greater focus on wellness and the chronically ill.

However, we are enthusiastic about our new payment model, the Alternative Quality Contract (AQC) which now includes more than a third of our provider network and slightly less than half of our in-state HMO membership. The early results show the AQC is achieving our twin goals to both improve the quality of patient care and reduce the historical rate of increase in health care costs.

In the contract’s first year (2009), the AQC groups produced the greatest one-year improvement in quality performance ever seen in our network. At the same time, these groups have moderated the rise in medical spending faster than the rest of the network and are on track to achieve our original 2008 goal to reduce annual medical cost trends by one half over five years. In fact, the Attorney General’s report notes that the average annual medical expense trend of the initial AQC groups is roughly half the current trend in the fee-for-service market as noted by the recent study by the Massachusetts Division of Health Care Finance and Policy.

There is near universal agreement among health care policy experts that the path to affordability begins with redesigning care. The AQC is playing a key role in helping these groups redesign care to emphasize value over volume. This redesign of care will reduce health care spending over time and sow the seeds of a sustainable health care system. For the past 50 years, providers have created margins through volume. The AQC represents a significant cognitive shift in that it allows providers to produce a margin by performing on the quality of patient care.

The Boston Business Journal reports here that other insurers reacted quickly:

In a statement, Mass. Association of Health Plans president Lora Pelligrini agreed with Coakley that limited and tiered networks and "greater transparency" are essential tools in the health insurance industry. But she also sought to focus attention on the recommendations related to the health care institutions themselves.

"Providing immediate relief to Massachusetts businesses and residents requires dealing directly with the price of services," the statement read. "As the Legislature considers measures to reform the state's health care payment system, we would urge that House and Senate leaders first to address the market power issues highlighted by the attorney general to make health care affordable for employers and consumers and to lay the appropriate foundation for payment reform."

The business group AIM, Associated Industries of Massachusetts, gets the prize for best jazzing-up of a wonky subject, for its blog post here:

Looking for a blockbuster to read at the beach this summer? Attorney General Martha Coakley and the Mystery of Spiraling Health Care Costs should be at the top of every employer’s reading list.

OK, it may not have quite the suspense of Stieg Larsson, but the attorney general’s newest release has some eye-popping lessons both for employers looking to reduce their health costs and policymakers seeking to overhaul the entire health care system.

Its takeaway: AIM and the Employer’s Campaign for Affordable Health strongly urge Massachusetts employers to read the attorney general’s report. Here’s the simple truth – we cannot lower health insurance costs unless employers are engaged and informed. Please post your comments and questions about the report in the comment section below.

And it did reap this highly literate comment:

Like the small child who said “But he has nothing on at all” in Hans Christian Anderson's "The Emporer's New Clothes", Attorney General Coakley once again tackles the myths of entrenched interests with realities that support the public interest for change. Detractors will use the same old demagoguery to continue to postpone dramatic change in favor of "tweaking" the current health care system. Dramatic change can be incremental. However, a protracted process should not diminish the necessity and immediacy of the actions and the goals.

This program aired on June 22, 2011. The audio for this program is not available.

Headshot of Carey Goldberg

Carey Goldberg Editor, CommonHealth
Carey Goldberg is the editor of WBUR's CommonHealth section.



More from WBUR

Listen Live