The Massachusetts Senate passed sweeping healthcare reform legislation S. 2022, An Act Furthering Health Empowerment and Affordability by Leveraging Transformative Health Care. The HEALTH Act, which passed by a vote of 33-6, focuses on both short and long terms goals regarding how to strengthen our healthcare system by lowering costs, improving outcomes, and expanding access. The legislation is the result of an effort by the Special Senate Committee on Health Care Cost Containment and Reform to address the healthcare system by analyzing the best practices in other states and engaging stakeholders in a series of meetings over the last year. Senator Jason Lewis, who serves as Senate Chair of the Joint Committee on Public Health, serves on this Special Senate Committee, as well.
Healthcare costs are continuing to strain the budgets of working families, businesses, and municipal and state governments. The Senate has continued to push for reforms to the current system through diligent research, stakeholder engagement, and legislation. The working group of Senators, with logistical support from the Milbank Memorial Fund, spent the last year meeting with officials from seven states, healthcare experts, and stakeholders to examine best practices regarding lowering costs and improving outcomes.
The bill implements more effective care delivery such as telemedicine and mobile integrated health, in order to reduce emergency room visits and expand provider versatility, while also addressing price variation between larger hospitals and their smaller community hospital counterparts. A recent study by the University of California Davis Health system estimates that “by using telemedicine for clinical appointments and consultations, its patients avoided travel distances that totaled more than 5 million miles. Those patients also saved nearly nine years of travel time and about $3 million in travel costs.”
The bill aims to reduce hospital re-admissions and emergency department use through mobile integrated health and telemedicine as well as expanding access to behavioral health. The Massachusetts Health Policy Commission has estimated that 42 percent of all emergency department visits are avoidable.
The bill aims to tackle provider price variation, the variation between providers for similar procedures, by implementing a floor for providers while also setting a benchmark for hospital spending. If hospitals exceed the benchmark the state will implement fines or penalties on those institutions.
“This important legislation takes meaningful steps to both improve healthcare quality and outcomes, as well as contain costs,” said Senator Jason Lewis. “More deeply, this legislation furthers efforts to address the social determinants of health that are responsible for many health inequities in our system; and, innovative steps are taken to make prevention a more central component of our healthcare system, which will improve our quality-of-life and save money.”
This bill takes a number of important steps to further our efforts around prevention and wellness – to continue to move our healthcare system from a “sick care” system to a “well care” system, central to Senator Lewis’ approach to public health. The bill will further strengthen and encourage efforts to move our healthcare payment system away from fee-for-service and toward a system that rewards better health outcomes. It reauthorizes and updates the successful Prevention and Wellness Trust Fund, and will provide new sources of funding for population health efforts that seek to prevent costly and preventable chronic health conditions. It expands access to basic preventative health services, including physical health, behavioral health, and oral health. And, it supports greater access to supportive housing services and other efforts to address the social determinants of health.
Post-acute care in an institutional setting and long term care and supports (LTSS) cost the state an estimated $4.7 billion in 2015, a major cost driver for MassHealth. The bill increases transition planning for patients into community settings and strengthening coordination between providers.
Pharmaceutical costs have been a driver of increased healthcare costs for a number of years. The Center for Health Information and Analysis (CHIA) reported a 6.4 percent growth in pharmaceutical spending in 2016. Drug costs are making families choose between filling prescriptions and paying for other essentials like housing and food. The bill implements greater oversight and transparency in drug costs and encourages Massachusetts to enter into bulk purchasing arrangements, including a multistate drug purchasing consortium like other states, to lower costs and protect consumers.
The legislation encompasses the whole system from Medicaid to the commercial market, addresses price variation, increases price transparency for consumers, leverages better federal funding opportunities, and expands scope of practice for many practitioners including dental therapists, optometrists, podiatrists, and nurse anesthetists.
The bill now heads to the House of Representatives for consideration.