Massachusetts pricing committee says patients need protection from excessive bills

The committee of hospital leaders, healthcare policy experts and government officials assembled to address Massachusetts' pricing disparity have taken up the topic of exorbitant bills for out-of-network healthcare, according to a State House News Service report published by The Lowell Sun.

The 23-member panel was established through legislation passed in May to avoid putting a controversial ballot question on the voting ticket. If passed, the ballot initiative would have redistributed money from the state's highest paid hospital systems to their lower-paid competitors.

Committee members recently met for the fourth time, and they came to a consensus on the need to protect patients from high-priced bills for out-of-network healthcare.

Returning to government rate setting or using price caps to control costs were among the possibilities discussed.

"Rate setting, probably not. I don't see any real groundswell to get into rate setting," House Majority Leader Ronald Mariano, said in the report in response to a presentation that included a discussion of how Maryland has used the practice to reduce price variation.

But Mr. Mariano was a little more open to the idea of rate capping, which allows more flexibility for negotiations without full government control, according to the report.

"The use of rate caps as it applies to a percentage of Medicaid may be something you could look at as a short-term solution to close the gap so there is an opportunity to maybe take a look at that and see if it fits what we're trying to do," he said.

Secretary of Health and Human Services Marylou Sudders told State House News Service,"There's obviously, I would say, general agreement, around out of network, but I don't think [it] goes to the heart of price variation. My interest would be, my own personal professional interest would be more of finding the incentives to have individuals in value-based organization rather than disincentives."

The commission appeared to agree reforms are needed to protect patients in emergency care situations, according to the report.

The committee has until March 2017 to issue a report.

 

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