NASHVILLE, Tenn., Feb. 19 HealthLeaders-InterStudy, a leading provider of managed care market intelligence, reportsthat Massachusetts' ambitious near-universal healthcare reform initiativewrapped up a successful first year, but the rising cost of healthcare andhigher-than-expected enrollment threaten to undermine Commonwealth Care andCommonwealth Choice in year two. According to the latest New England HealthPlan Analysis, local healthcare officials and Blue Cross Blue Shield ofMassachusetts are bringing ideas to the table to address the issues now.
"As concerns have begun to mount over cost, both the health plan andhospital association are attempting to take proactive steps, floating ideas toframe the discussion," states Ric Gross, market analyst for HealthLeaders-InterStudy and author of the report.
Blue Cross Blue Shield of Massachusetts reacted to the issue of risinghealthcare costs by announcing it wants to quit paying providers for eachvisit or treatment, but instead pay a flat payment per patient each year,adjusted for age and sickness. In addition, the health plan said it would paya significant bonus if the providers improve care.
The health plan association released a comprehensive set ofrecommendations, and includes a mixture of legislative proposals and voluntarymeasures, designed to target rising costs. In a 17-point legislative package,the association addresses everything from public reporting and non-billing ofpreventable errors to making greater use of managed Medicaid. The state'shospital association also tackled the issue, putting forth an agenda thatincludes efforts for administrative simplification; addressing the workforceshortage, especially as it relates to nurses; and instituting a chronic-caredisease management program around diabetes, though that plan is still in itsinfancy.
The New England Health Plan Analysis report includes coverage of theMaine, Massachusetts, New Hampshire, Rhode Island and Vermont health planmarket. For additional insight into the first year of Massachusetts'healthcare reform initiative, log on to our website to download an interviewwith Ric Gross, HealthLeaders-InterStudy's market analyst covering the NewEngland healthcare market.
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