Devaux says Health Policy Commission needs more power

For some time, the Health Policy Commission has been urging lawmakers to increase the powers of the agency so it can better rein in rising hospital costs.

Deborah Devaux, the new chair of the agency, is voicing the same message but with a bit more urgency. In an interview on CommonWealth’s Health or Consequences podcast with John McDonough of the T.F. Chan School of Public Health at Harvard University and Paul Hattis of the Lown Institute, Devaux said it’s time for action.

“I believe the powers need to be changed and strengthened,” she said. “We need to consider new approaches because the challenges and issues have changed over the last 10 years, and accelerated in the last three years.”

A top concern is that half of all patients report deferring medical care because of the high cost, she said. 

Devaux said her priority is to strengthen accountability for the state’s cost growth benchmark, the commission’s target for health care spending growth. The benchmark appeared to work well for many years, but has been sputtering of late.  

The consensus on the commission is that the cost growth benchmark needs more muscle behind it. Devaux said the commission needs the power to dole out financial penalties for organizations that repeatedly exceed the benchmark.  

“We hope we never have to apply those penalties, but they serve as an important factor in the focus on cost,” she said. 

Devaux said the state needs to gather data on the drugs contributing the most to cost growth and the ability to set target pricing for those drugs. And she said health insurers need more regulatory attention, suggesting the commission should set targets and standards for premiums and cost sharing.

Devaux also said the commission needs more control over the issuance of performance improvement plans. Performance improvement plans are currently the commission’s primary enforcement mechanism for holding health care payers and providers accountable for spending in excess of the health cost benchmark. 

For the first time in its 10 years in existence, the commission in January ordered Mass General Brigham to develop a performance improvement plan. It took nine months for the commission and the state’s largest hospital system to come to agreement on a plan to rein in costs by roughly $128 million a year.

“We have really appreciated the responsiveness and commitment of MGB through the performance improvement plan,” Devaux said. “I was very respectful of how MGB came to the table.”

But Devaux suggested the process may need some tweaks. She said the commission should have more authority in setting spending targets and identifying the strategies used to reach those targets. She also said the commission needs the power to hand out financial penalties for persistent noncompliance with the cost growth benchmark.




Hodgson gets support from Baker-linked super PAC: A super PAC with close ties to Gov. Charlie Baker on Friday reported spending $294,000 on behalf of 33 candidates, with the biggest chunk of money ($32,125) going to support Bristol County Sheriff Thomas Hodgson, one of former president Donald Trump’s biggest supporters in Massachusetts.

– The Massachusetts Majority PAC also spent significant amounts on behalf of three Republicans challenging Democrats in the Senate. The PAC spent $23,312 on behalf of William E. Johnson of Granby, who is challenging Democrat Rep. Jacob Oliveira of Ludlow for the Senate seat being vacated by Eric Lesser; $20,995 on behalf of Edward F. Dombrowski Jr., of Wakefield, who is challenging incumbent Sen. Jason Lewis of Winchester; and $20,176 on behalf of Rep. Shawn Dooley of Norfolk, who is challenging incumbent Sen. Becca Rausch of Needham. Read more.


Out of control: Peter Pitts of the Center for Medicine in the Public Interest says a poorly regulated drug pricing program is padding the profits of hospitals and spiraling out of control. Read more.

Yes on 4: Gladys Vega of Collaborativa and Bob Hildreth of La Vida Scholars urge a yes vote on Question 4 for fairness and safety reasons. Read more.

Gig questions not going away: Charles Chieppo of the Pioneer Institute says voters dodged a bullet when the Supreme Judicial Court shot down a ballot question on gig workers, but now the Legislature will have to decide the issues at stake without much solid information to go on. Read more.





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