Health care chairs vow action on price variation

THE CO-CHAIRS OF THE Legislature’s Joint Committee on Health Care Financing may be new to their posts, but both seem to grasp the urgency of tackling big issues facing the state’s health care sector and both sound optimistic about solutions to some thorny problems emerging in the current session on Beacon Hill.

That’s the takeaway from a conversation with Sen. Cindy Friedman and Rep. Jennifer Benson convened by Paul Hattis and John McDonough as part of their “Health or Consequences” interviews on The Codcast.

One of the biggest issues looming over the health care sector: the large price variation in what hospitals charge for similar services, a problem that vexed lawmakers last session, as they adjourned without reaching agreement on an approach to dealing with it.

“This is a very, very, very big issue, and it is not something that we’re going to be able to skirt if we really are going to address health care costs,” said Friedman. She said there’s a need to address issues “at both ends of that spectrum” — dealing both with the much higher costs charged by big teaching hospitals while also making sure community hospitals aren’t bringing inefficiency to the overall system by trying to add costly services already provided elsewhere.

“I think this is the most complicated issue that we have facing us,” said Benson, a Democrat from Lunenburg.

Too many patients “drive past” community hospitals near their home and head to Boston teaching hospitals when they don’t need to, she said. “By choosing to go to a Mass. General where it might cost twice as much as your community hospitals you’re not necessarily going to get better outcomes.”

Though they didn’t reveal much in the way of specifics of a potential plan to deal with the issue, the co-chairs both pronounced the odds favorable for legislation passing this session that addresses hospital price variation.

“I think good. I’m going to be positive,” said Benson.

“We can’t avoid it and say we’re covering the issues around health care,” said Friedman, agreeing with that assessment.

They both also sounded optimistic about the chances of dealing with the issue of “surprise billing” — when a patient getting care that is broadly covered by insurance gets hit with a charge for a specific service as part of it, say, the role of an anesthesiologist in surgery, because that provider is outside their covered network.

Benson claimed first-hand knowledge of the problem, “so I understand this very acutely,” she said.

Benson explained that when she went to a dermatologist for skin cancer screening she ended up with a “several hundred dollar bill” because a biopsy was sent to a lab that wasn’t in her covered network.

“We both are pretty clear that he patient has to be removed from this process,” Friedman said of the need to ensure that consumers shouldn’t have to track every element of their recommended care in relation to their coverage plan.

On the issue of pharmaceutical drug costs, it’s less clear where the Legislature will land. Both lawmakers sounded optimistic about dealing with high costs to the state’s Medicaid program. But the conversation was recorded before the House finalized its budget plan, which weakened a provision Gov. Charlie Baker had in his budget proposal to allow the state to apply pressure on drug companies to lower costs for high-cost treatments. The Senate releases its budget plan on Tuesday.

On the national health care topic of the day — Medicare for all — both lawmakers said they are sympathetic to the goal of a nationwide system, but would be very wary of any effort to go it alone and enact a state-based single-payer system in Massachusetts. Friedman went further, adding that even at the national level she’s not sure the public is really on board.

“And if the public isn’t ready, it cannot work, because it will require such a shift in how we provide medical care and what our health care system looks like,” she said. “If people aren’t ready for that or desperate for something brand new, it is going to be very hard to implement.”

Correction: This story was updated to say that the House budget weakened a provision in the governor’s budget to address MassHealth pharmaceutical costs. It did not remove the provision.