State Senate’s New Reform Bill Raises Cautions

The healthcare “cost-containment and reform” bill that the Massachusetts Senate passed at midnight last Thursday offer some positive steps forward –such as expanded patient access to telemedicine services – but is also fraught with new layers of regulation over existing regulation, penalties, and problematic new benchmarks that were all passed at a time when uncertainty from Washington has placed continuing federal support for the state’s reform efforts in question.

The bill sets a benchmark for commercial hospital spending far below the existing statewide total healthcare spending benchmark of 3.1%. Separating out hospital spending at a time when hospitals have been driven to coordinate intertwined healthcare entities encompassing all part of the healthcare system appears to run counter to the state’s own “global payment” or “accountable care” models based on total medical expense.

Among other provisions, the Senate’s bill includes an aggressive and punitive readmission standard that runs counter to the experience of national readmission-reduction efforts that are beginning to recognize that the causes of readmissions run far beyond a hospital’s control.

The final Senate bill did make some important fixes to initial Senate language relating to the prohibition of facility fees. By adopting a re-draft of an MHA-endorsed amendment, the Senate recognized the potential effect its language posed to important community services and preserved the ability of existing facilities to receive such fees. 
“The broad intent of the Senate bill – reducing costs and improving quality – is a goal that hospitals and the wider healthcare community  share and we applaud the Senate for its effort,” said MHA President & CEO Steve Walsh. “We look forward to continuing the discussion to make sure that access for patients doesn’t become inhibited by the unintended consequences of well-meaning proposals.”