Commission wraps up health pricing discussions

As ballot question talks go on, agency’s role unclear

THE STATE’S HEALTH POLICY COMMISSION on Thursday wrapped up a series of discussions with industry stakeholders on what to do about hospital pricing disparities, but the group seemed to have no clear plan on what to do next.

As members offered up their ideas at the end of a two-hour meeting, some talked about broadening the group of stakeholders. Others advocated for small steps that could be taken to address the pricing disparities. Still others said it was time to stop talking and take action. They noted that study after study has shown a handful of hospitals, led by Massachusetts General and Brigham and Women’s of Partners HealthCare, routinely charge much higher prices for services with no discernible difference in quality or outcome.

“The strong are getting stronger and the weak are getting weaker,” said David Spackman, the general counsel at Lahey Health.

As the group debated what to do next, it was unclear if their deliberations would have any impact  on a Beacon Hill effort to grapple with the problem. SEIU1999 is pushing a ballot question that would bar licensed commercial health insurers from paying any hospital more than 20 percent above or 10 percent below the “carrier-specific average relative price” for a service.

Officials from the union and Partners HealthCare, as well as lawmakers and administration officials, are reportedly discussing possible legislative alternatives to avoid a costly ballot fight. Several business and insurance groups have raised concerns about where those talks might be heading.

David Seltz, the executive director of the Health Policy Commission, said no one from his staff is participating in the Beacon Hill discussions. Stuart Altman, the chairman of the commission’s board, said he wasn’t participating in the Beacon Hill talks. He said he assumed the participants were paying attention to what the Health Policy Commission was doing, but he said he didn’t know for certain whether that was the case.

“I can’t say what is going on,” he said.

Meet the Author

Bruce Mohl

Editor, CommonWealth

About Bruce Mohl

Bruce Mohl is the editor of CommonWealth magazine. Bruce came to CommonWealth from the Boston Globe, where he spent nearly 30 years in a wide variety of positions covering business and politics. He covered the Massachusetts State House and served as the Globe’s State House bureau chief in the late 1980s. He also reported for the Globe’s Spotlight Team, winning a Loeb award in 1992 for coverage of conflicts of interest in the state’s pension system. He served as the Globe’s political editor in 1994 and went on to cover consumer issues for the newspaper. At CommonWealth, Bruce helped launch the magazine’s website and has written about a wide range of issues with a special focus on politics, tax policy, energy, and gambling. Bruce is a graduate of Ohio Wesleyan University and the Fletcher School of Law and Diplomacy at Tufts University. He lives in Dorchester.

About Bruce Mohl

Bruce Mohl is the editor of CommonWealth magazine. Bruce came to CommonWealth from the Boston Globe, where he spent nearly 30 years in a wide variety of positions covering business and politics. He covered the Massachusetts State House and served as the Globe’s State House bureau chief in the late 1980s. He also reported for the Globe’s Spotlight Team, winning a Loeb award in 1992 for coverage of conflicts of interest in the state’s pension system. He served as the Globe’s political editor in 1994 and went on to cover consumer issues for the newspaper. At CommonWealth, Bruce helped launch the magazine’s website and has written about a wide range of issues with a special focus on politics, tax policy, energy, and gambling. Bruce is a graduate of Ohio Wesleyan University and the Fletcher School of Law and Diplomacy at Tufts University. He lives in Dorchester.

The commission said in January that Massachusetts policymakers needed to address the pricing disparity among hospitals. The commission then convened a large group of stakeholders and held discussions on different ways of curbing the price disparity, including reducing consumer demand for high-priced health services and incentivizing health care providers to offer care in different, more efficient ways.

On Thursday, the group heard from Joshua Sharfstein, the former secretary of the Maryland Department of Health and Mental Hygiene, who talked about how his state has had success regulating health care prices. While many in the audience were fascinated with the approach, there seemed to be consensus that such a massive regulatory intervention was unlikely to happen soon, if ever.