HealthLeaders- InterStudy, a leading provider of managed care market intelligence, reports that Massachusetts' ambitious near-universal healthcare reform initiative wrapped up a successful first year, but the rising cost of healthcare and higher-than-expected enrollment threaten to undermine Commonwealth Care and Commonwealth Choice in year two. According to the latest New England Health Plan Analysis, local healthcare officials and Blue Cross Blue Shield of Massachusetts are bringing ideas to the table to address the issues now.
"As concerns have begun to mount over cost, both the health plan and hospital association are attempting to take proactive steps, floating ideas to frame the discussion," states Ric Gross, market analyst for HealthLeaders- InterStudy and author of the report.
Blue Cross Blue Shield of Massachusetts reacted to the issue of rising healthcare costs by announcing it wants to quit paying providers for each visit or treatment, but instead pay a flat payment per patient each year, adjusted for age and sickness. In addition, the health plan said it would pay a significant bonus if the providers improve care.
The health plan association released a comprehensive set of recommendations, and includes a mixture of legislative proposals and voluntary measures, designed to target rising costs. In a 17-point legislative package, the association addresses everything from public reporting and non-billing of preventable errors to making greater use of managed Medicaid. The state's hospital association also tackled the issue, putting forth an agenda that includes efforts for administrative simplification; addressing the workforce shortage, especially as it relates to nurses; and instituting a chronic-care disease management program around diabetes, though that plan is still in its infancy.
The New England Health Plan Analysis report includes coverage of the Maine, Massachusetts, New Hampshire, Rhode Island and Vermont health plan market. For additional insight into the first year of Massachusetts' healthcare reform initiative, log on to our website to download an interview with Ric Gross, HealthLeaders-InterStudy's market analyst covering the New England healthcare market.
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