Payment Reform: Not This Year

The push to payment reform for health providers has apparently stalled, at least for this year, according to a report in today’s Boston Globe, which described the main reason for the delay as “disagreements among key officials, legislators, and providers over how best to control health care spending.”

Despite consensus among many that the current fee-for-service system contributes to escalating costs, and a recommendation from a state commission one year ago that the state adopt a new payment system quickly, Senate President Therese Murray told the newspaper that she will not file legislation to change the system this year as she originally planned. Ms. Murray attributed the delay in part to the “logistical and political complexity of changing a system that has been in place for decades,” according to the Globe report.

The Special Commission on the Health Care Payment System (which included current MMS President Alice Coombs, M.D. as a member) has recommended that the state move away from a fee-for-service system to one of  “global payments,” which offers providers a set payment for all of a patient’s care for a year.  Yet Ms. Murray told the Globe that global payments may not be right for all providers. Health care “is a huge portion of our economy and workforce, and we don’t want to negatively affect our economy,” she said.

According to the Globe story, drafts of legislation on health care cost control have been passed between the Patrick administration and Senate leaders, but full agreement is yet to be reached on specifics.

The Globe story also said that the Massachusetts Hospital Association “plans to release a detailed plan this month for establishing a board to oversee the transition to a new payment system.”

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