The Massachusetts House has approved a measure that uses $247.5 million in assessments on insurers and $90 million on large hospitals to provide community hospitals with financial stability, reports State House News Service.
The legislation, approved June 19 with primarily Democratic support, aims to help lower-cost community hospitals amid changing healthcare industry cost and reimbursement pressures.
"It is our hope that over the three years of this bill, and the three years of support that these hospitals will get, the dynamic in healthcare will change," House Majority Leader Ronald Mariano said, according to the report. "And I'm not going to say we won't be here three years from now making adjustments on what healthcare looks like then, but we will at least know that we have done things to put these hospitals on a very strong and firm footing. And that's the focal point of the bill, probably the largest endeavor that we take under this bill and probably the most important thing that we can do in this bill."
The support to community hospitals will be provided through grants, which will be based on patient acuity and patient mix, among other factors, reports State House News Service.
The bill comes as state spending on MassHealth, which combines the Medicaid and the Children's Health Insurance Program, has increased. In addition to the assessments, the bill urges the Betsy Lehman Center, a state agency focused on safer healthcare, to provide lawmakers with medical insight to help them in making determinations about scope of practice changes for healthcare professionals, according to the report.
Other components of the bill include creating telemedicine standards, as well as delegating task forces to further research various concerns, such as administrative costs. Additionally, the bill addresses surprise and out-of-network billing by giving authority to the state's Division of Insurance to examine whether there is unjustified pricing in provider contracts, and the state's Health Policy Commission the power "to require performance improvement plans with financial penalties for noncompliance attached," according to the report. A hospital would be able to use medical research as a defense for higher pricing.
Moving forward, the bill will likely make it to a Senate conference committee that last year approved a different version of the legislation, according to the report. That Senate bill, the report states, calls for a rate floor for insurer payments to hospitals at 90 percent of the Massachusetts average. Lawmakers now have the option of agreeing on and passing a consensus bill before formal sessions end next month.
Access the full State House News Service story here.