Gov. Charlie Baker plans to reiterate health care reform legislation, two years after tabling a bill to increase spending on primary and behavioral health care.
“We’re going to get back to this one,” he told the New England Council on Tuesday.
Baker said Medicare payments underestimate services such as behavioral health, addiction treatment, primary care and gerontology, resulting in underfunding.
According to the State House News Service, the bill Baker tabled in October 2019, one of many set aside by the arrival of COVID-19, would have required further investment in these areas from suppliers and insurers.
Baker’s first crack in this legislation forced hospitals, physician groups and insurers to disclose how much they are currently spending on primary care and behavioral health. By 2023, spending in these two areas is expected to increase by 30%, without exceeding the annual ceiling for health spending.
This additional financial commitment would be offset by higher reimbursements from insurers for these services. Massachusetts is estimated to spend only about 11% to 15% of its health care dollars on primary care and mental health.
Suppliers or insurers who fail to comply would be subject to scrutiny by state regulators
Baker’s initiative would have brought Massachusetts closer to other industrialized countries, which spend much less on health care but have a higher life expectancy than the United States.
This is because these countries place a lot more emphasis on primary care than we do. Their gatekeepers can often dispense preventative solutions that can avoid the need for more sophisticated – and expensive – procedures later.
The result of this imbalance means that the vast majority of health care resources in this country go to hospital services, specialty care and prescription drugs.
The Governor’s Bill also followed the lead at the federal level to replace the fee-for-service model – the amount of care billed instead of quality – with a model that rewards positive patient outcomes, not volume.
These proposals for redistributing resources have not received a warm welcome from many Boston hospitals and others accustomed to providing high-tech medical solutions; they called these state-mandated measures unrealistic.
Baker told the New England Council that his bill, which he said he would likely table by January, couldn’t be more timely.
“Now we have bigger challenges in this space than before the pandemic …”
The News Service said Baker’s comments dovetail with those of Senate Speaker Karen Spilka and Speaker of the House Ronald Mariano, both of whom identified mental health and health care in general as top legislative priorities.
Public bodies including the Health Policy Commission and the Massachusetts Health Connector recently reported the rising costs facing Massachusetts consumers.
Last week, the Health Connector approved several plan offers for 2022, with a cost increase that some board members said was unsustainable.
The plans feature an average premium increase of 6.9% for the 85,138 members whose medical coverage is not subsidized or who receive advance tax credits on premiums.
With the aging of members taken into account, the increase in the rate of 6.9% for non-subsidized non-group members becomes a jump of around 8.5%.
Nancy Turnbull, who previously worked at the State Insurance Division and Harvard School of Public Health, noted that next year’s average premium increases are “twice, if not more” than the current cap. benchmark of 3.1% of health care costs.
The Policy Commission on Wednesday recommended several measures in response to these ever-increasing costs.
Approved unanimously, they include price caps for the most expensive providers, a more in-depth review of outpatient and outpatient hospital extensions, and new affordability standards for health plans.
The recommendations are part of HPC’s annual cost trends report, which explores the 4.3% growth in total state health spending from 2018 to 2019.
We don’t know if Baker’s new bill will accurately reflect his previous efforts, but to demand that cost caps be met and sufficient resources allocated to historically underfunded and undervalued sectors like primary care and healthcare. mental health should be its primary focus.