Panel badly split on health care pricing

STATE HOUSE NEWS SERVICE

DIFFERENCES AMONG MEMBERS of a 23-person commission examining health care pricing variations were on full display Tuesday on the 21st floor of One Ashburton Place.

Commission members discussing potential recommendations quickly disagreed over whether hospital prices are low are not, comparatively speaking, and members made clear that uncertainty over the federal health care access law is casting significant doubt over the panel’s deliberations.

“There is not unanimity at this table,” commission co-chairman Rep. Jeff Sanchez of Jamaica Plain said during a debate that pivoted at points on how recommendations might affect lower cost community hospitals and higher cost teaching and research hospitals.

The panel plans on March 15 to file its report and members spent less than two hours Tuesday going over its wording, working off a draft that was not made available to the media or dozens of industry insiders who attended the meeting.

Ultimately, the panel’s work and recommendations will be forwarded to the Legislature and lawmakers can use the ideas “as they see fit,” said Health and Human Services Secretary Marylou Sudders. “This is not a Quaker consensus meeting,” she said.

House Majority Leader Ronald Mariano, a commission member and veteran of the state’s health care policy debates and struggles, used the word “cemetery” Tuesday when he meant to say “summary.” He then told his fellow commissioners, to laughter, “I know you guys worked hard but it may end up in the cemetery.”

Members also found ample room to disagree over whether variations are “warranted” or “unwarranted,” the crux of the issue they were charged with examining.

Dr. David Torchiana, CEO of Partners HealthCare, warned against recommendations that could hurt teaching hospitals as they compete against their national counterparts.

Torchiana called rising MassHealth enrollment, which is emerging as the major issue in this year’s state budget debate, a “catastrophe” and described the pending repeal and replacement of the Affordable Care Act as a “pending catastrophe.”

“We have one catastrophe, which is we’ve had a dramatic expansion of Medicaid. We have a pending catastrophe as the Affordable Care Act gets repealed and replaced. If we go forward with price variation solutions that are unwarranted by the current circumstances, we are adding a catastrophe, particularly for our important institutions,” Torchiana said.

In a law approved last May to avert a ballot question fight, the Legislature and Gov. Charlie Baker tasked the commission with conducting “a rigorous, evidence-based analysis to identify the acceptable and unacceptable factors contributing to price variation in physician, hospital, diagnostic testing and ancillary services.” The commission, which was also directed to recommend steps to reduce provider price variation, has been holding regular meetings.

Lawmakers instructed the commission to include legislation with its report “if the commission determines that legislation is necessary to address price variation issues identified during its deliberations.”