ADJOURNED 'til Monday at 11 a.m. (Informal)
ADJOURNED 'til Monday at 11 a.m. (No Calendar)


By Andy Metzger

STATE HOUSE, BOSTON, NOV. 2, 2017....The Massachusetts Senate plans to debate a massive health care reform bill over two days next week, digging in on a series of issues that have long vexed policymakers who are balancing access to care with constant concerns over rising costs.

The bill (S 2190), scheduled to hit the floor before lawmakers embark on a seven-week break in mid-November, gives employers the chance to opt in to MassHealth plans and, in a nod towards regulation, sets target reimbursement rates for lower-paid hospitals that are 90 percent of the statewide average.

"It's a major vision for cost-containment strategies without compromising access, quality and hopefully improving outcomes. It's based on a year's worth of research," Senate President Stan Rosenberg told the News Service on Thursday.

The Senate plans to set a 5 p.m. Monday amendment deadline and then debate the bill Wednesday and Thursday, Nov. 8 and Nov. 9, Rosenberg said.

The biggest expenditure in the state budget, MassHealth has long been squeezing out other spending priorities and Gov. Charlie Baker this summer warned that without reforms "corrective action will be needed" to the state budget.

Lawmakers rejected the governor's proposal, opting to develop their own approach toward health care reform. The Ways and Means bill reflects work done by the Milbank Foundation, the Special Commission on Provider Price Variation, and research on other states, Rosenberg said.

Rather than emerging through the House-Senate committee process, the bill was drafted by the Special Senate Committee on Health Care Cost Containment and Reform. The bill polled by the Senate Ways and Means Committee Thursday was almost identical to the special committee's proposal, according to an aide.

"This area is so big that there's room for a lot of other ideas and we hope others will put other ideas on the table," Rosenberg said.

The Ways and Means Committee issued a summary with the poll that closed late Thursday morning.

The bill, which states its intent is "to further health empowerment and affordability while leveraging transformative health care," moved out of Ways and Means with a favorable recommendation, with 14 members voting in favor and three reserving their rights, or not voting for or against the bill.

Nov. 15 is the last day of formal sessions this year under rules designed to prevent holiday season and lame duck legislative sessions.

The bill arrives on the heels of an American Hospital Association report showing hospitals, health systems and other providers spend nearly $39 billion a year on administrative activities assocated with regulatory compliance, and as Washington continues to consider major health care policy decisions.

"While debate in Massachusetts and in Washington focus on healthcare costs and healthcare access, a more general question merits attention: In the incessant effort to regulate all aspects of the healthcare community, is government creating a regulatory quagmire that is driving up costs?" the Massachusetts Hospital Association wrote in its latest weekly Monday Report.

The hospital noted the Senate bill's inclusion of language expanding access to telemedicine and the establishment of "an aligned measure set for the state and health insurers to use in contracting with healthcare providers," which the association says will make it easier for consumers to make care quality comparisons and for providers to focus on quality improvements. Notably absent from the bill, the association noted, are Baker's MassHealth reforms.

[Michael Norton contributed reporting]


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