HPC urged to weigh in on nurse ballot question

Health plans: Commission should estimate cost of staffing initiative


CITING COMPETING CLAIMS from both sides of a nurse staffing ballot question, health insurers on Wednesday asked a state agency to produce in the next month an independent analysis of the costs associated with Question 1.

In a letter to Health Policy Commission executive director David Seltz, the Massachusetts Association of Health Plans asked the commission to conduct a study gauging any potential increase in spending, the “likely per member per month impact,” and how any improvements to the quality of care “might offset this spending.”

Backed by the Massachusetts Nurses Association and opposed by groups including the Massachusetts Health and Hospital Association, the nurse-staffing initiative would cap the number of patients that can be assigned to one nurse at a time, with the specific ratio depending on the type of unit.

Proponents and opponents have offered dramatically different cost estimates, with supporters projecting an implementation cost of between $35 million and $47 million for the state’s 67 acute care hospitals. A report commissioned by the hospital association and released earlier this year, meanwhile, found that the change in policy would cost the health care system $1.3 billion the first year and $900 million annually in subsequent years while adding an additional $100 million in state obligations.

Lora Pellegrini, who heads the Massachusetts Association of Health Plans, said in the letter that her group believes “that if the higher cost estimates put forward are close to accurate, the question could significantly hamper our state’s efforts to control costs and would threaten our state’s ability to meet the health care cost benchmark.”

“We know that it is imperative we focus on bending the health care cost trend so that our state’s residents can remain insured,” she wrote. “Contradictory findings from proponents and opponents of this question make it hard for our organization to truly evaluate this proposal for its net impact on costs and quality improvement.”

Total health care spending in Massachusetts grew 1.6 percent to $61.1 billion in 2017, the Center for Health Information and Analysis reported last week.

The health insurers’ request for an independent review came the same day a Suffolk University/Boston Globe poll found 51.8 percent of likely voters supported the nurse staffing question, with 33 percent opposed and 15 percent undecided in a poll taken Sept. 13-17.

The letter said it would be “very helpful” if the commission would complete an analysis before its annual cost trends hearing, a two-day exploration of health care spending in Massachusetts that this year is scheduled for Oct. 16 and 17.

Meet the Author

Katie Lannan

State House News Service
Asked if it planned to conduct a review as per the insurers’ request, a Health Policy Commission spokesman provided a statement from deputy executive director Coleen Elstermeyer, who said the ballot question would be a “topic of discussion” at the cost-trends hearing.

“The ballot question on nurse staffing ratios is a significant health care policy issue that will have far-reaching implications, whether you are for or against the measure,” Elstermeyer said.

In a letter, House Minority Leader Brad Jones in May asked the commission to conduct the study of the nurse staffing initiative petition and take advantage of what he called “a unique opportunity to help inform the debate.”