Two Massachusetts health system CEOs shared their different views on healthcare regulation at this week's health cost trend hearings, according to Boston Business Journal reports.
Ralph de la Torre, MD, CEO of Boston-based Steward Health Care System, shared a perspective some might consider unique among healthcare executives. He wants the state government to enact more cost containment legislation that would further restrict prices for higher-cost hospitals and physicians. Dr. de la Torre says government intervention is needed to fix Boston's broken healthcare market —a difficult environment for Steward to compete.
"We not comparing [the price of] liver transplants, we don't provide them and we don't care," Dr. de la Torre said at the hearing, according to the report. "But CT scans, MRIs, hernias — there's price disparity that creates unfair competition."
Dr. de la Torre has two ideas for healthcare cost reform in Boston. One would hold more expensive hospitals to a lower cost-growth benchmark than their less expensive peers. Under Massachusetts' 2012 healthcare cost containment law, the state's healthcare system must abide by a 3.6 percent annual cost growth benchmark. Dr. de la Torre wants to adjust that metric for particular hospital systems, dividing the 3.6 percent by the cost factor of the hospital, which is determined in state health cost reports.
The second idea is a state healthcare system with insurer contracts that would create a direct relationship between how much hospital systems spend on care and how much patients pay in premiums. If Steward is given $8,000 to treat an individual patient, for example, and only spends $7,000 to do so, it could split the savings with the patient, according to the report. This would incentivize patients to visit lower-cost hospitals.
Howard Grant, JD, MD, president and CEO of Burlington-based Lahey Clinic differed on the role of the state government in healthcare. He urged the state to not be "skeptical of size" and to refrain from enacting rules that would restrain the growth of health systems like Lahey.
Lahey has expanded in recent years, and now includes Lahey Hospital and Medical Center, Beverly Hospital and Addison Gilbert Hospital. Another acquisition, Winchester Hospital, is in the works. Lahey is also in talks with Beth Israel Deaconess Medical Center to partner.
Dr. Grant refuted insurers' claims that larger systems have leveraged higher reimbursement rates in the past, arguing it's a different world now as providers move toward "a global payment system" that pays to keep people healthy rather than paying for volume, according to the report.
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