State Officials Attend April Board Meeting:

| April 26, 2017

The MassAHU Board of Directors recently invited the Attorney General’s office to discuss the state of Health Care in the Commonwealth at the April Board Meeting. Guests included Karen Tseng, Health Care Division Chief and Mary Beckman, Bureau Chief.

The discussion was driven primarily around the topics of transparency, waste and consumer choice and distilled down into three themes:

  • Provider Price Variation. Should the state intervene and if so how?  The issue is MA population is migrating to higher cost providers based on market power and perceived value.  Previous research has shown price does not equal higher quality or better results but displaying that information for consumers remains a challenge. MassAHU board members discussed the need for better tools.  It was noted that health plans appeared to be complying with the mandated transparency tools but that use of the tools was still sporadic.  Getting members/patients the information they need for the services they are about to have has not evolved yet. The MassAHU board also thanked the AG for their consistent oversight of provider merger activities to help keep the market power in check.
  • Rx Costs. Transparency around pricing needs to be considered.  The Rebate calculation is – at best – confusing and often there is $$ left on the table that could be in the employer and consumer’s hand. Here again the board shared that price transparency can play a bigger role.  Consumers need help understanding dosing, generic and lower cost brands alternatives – at the MD’s office so they can ask the right questions to find the right balance of cost and effectiveness for their illness.  MassAHU board shared stories of our client’s employees trying to determine the right RX that didn’t bankrupt the family.
  • Engaging consumers.  How can one be a consumer when facility fees and other billing dynamics confound patients and provider offices. Transparency on price here is important as well as developing tools to help decision support.  More quality information can be very helpful as well so patients have better comparison information.  AG/State can mandate information be submitted, but may need to invest in additional data analytics to produce the quality results that will be useful to consumers.

Category: Consumer & Industry News

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