A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

Public Hearing on Massachusetts Senate Health Care Package

Public Hearing on Massachusetts Senate Health Care Package

October 26, 2017

This Monday, Health Care For All testified before the Special Senate Committee on Health Care Cost Containment and Reform during a public hearing on the Senate health package (An Act furthering health empowerment and affordability by leveraging transformative health care) released the previous week. This major legislation affects a wide range of topics throughout the health care system. In our testimony, Health Care For All touched on a few of the provisions we think will impact consumers.

Major Items Highlighted by Health Care For All:

Prescription Drugs

Health Care For All supports the provision in this bill which authorizes an evidence-based education program for drug prescribers. To best prescribe to patients, doctors must keep up with a constantly evolving drug market and new clinical research. Meanwhile, the pharmaceutical industry spends billions of dollars in marketing directly to doctors, promoting new, high cost drugs even if these drugs don’t improve outcomes. This education program can help providers prescribe based on clinical data instead of promotional information.

HCFA also supports the introduction of transparency measures for prescription drug pricing. The rapidly rising cost of prescription drugs places major burdens on consumers and the state budget. However, Health Care For All urges for stronger transparency than is currently in the legislation. We believe that any information the state gathers on prices should be made available to the public, and that a substantial penalty should be levelled against any drug company that withholds pricing information.

Dental Therapists

Health Care For All strongly supports the authorization of dental therapists in this legislation. Dental therapists are mid-level providers who are trained to provide basic but vital services, including preventive dental care and basic restorative care such as filling cavities. Authorization for dental therapists will help expand these important services which too many Massachusetts residents are currently unable to access.

Another panel also testified on the importance of dental therapists. Dr. Kerry Maguire of Forsyth Kids spoke on the importance of dental therapists to increase the number of providers that can fill cavities for children, saying that currently, “if every dentist in the state picked up a dental drill and never put it down, we would still not be able to treat all the cavities out there. The problem is simply too great.”

Katherine Soal, a dental hygienist and former president of the Massachusetts Dental Hygienist Association, spoke on how dental therapists could help treat problems before they become severe. She gave the example of a patient she knew with cerebral palsy who developed an extreme dental issue and needed hospitalization, and she said that the hospitalization could have been prevented by early treatment from a dental therapist.

Maura Sullivan of The ARC of Massachusetts spoke on the benefits dental therapists could have for people with developmental disabilities. She said she has worked with the state to ensure dental therapists will have training in providing oral health care to people with these disabilities. She spoke on the difficulty she has had in finding a dentist for her own children, and said that dental therapists with this training could benefit many patients who currently have trouble finding dentists who are willing to treat individuals with developmental disabilities.

MassHealth

Health Care For All was also pleased by the decision to not include damaging provisions in this legislation. Last summer, the Governor proposed a series of MassHealth cuts that would have reduced eligibility, limited benefits, and imposed barriers to keeping coverage and continuity of care. Many of these cuts required legislative authorization, and the Senate referred the issues to this Senate special committee. The committee did not include these provisions in this legislation, which shows their disapproval of the proposed cuts.

Prevention and Wellness Trust Fund

Health Care For All commended the Senate working group for including reauthorization of the Prevention and Wellness Trust Fund in this legislation. The PWTF is a successful pilot program which promotes public health through preventive care and promotion of healthy behaviors. Public health is an extremely important area of focus as it improves quality of life and cuts down on costs. It’s generally much cheaper to invest in keeping people healthy than paying for costly care when people become sick. Health Care For All urged the Senate to include a permanent source of funding for the program in this legislation.

Hospital Readmissions

Health Care For All supports steps taken in this bill to reduce hospital readmissions. Hospital readmissions occur when a patient is released from a hospital and returns within 30 days. This can be a stressful situation for the patient, and sometimes indicates that an issue was not adequately dealt with in the hospital or that there was not enough done to connect the patient with resources outside of the hospital. Not all readmissions are preventable, however, and Health Care For All recommends focusing on preventable readmissions. This is also an issue of cost. Readmissions drive up costs for the patient and the health care system overall by increasing the number of costly hospital visits. Readmissions in Massachusetts have increased in recent years, adding stress for patients and increasing costs.

This bill aims to decrease readmissions by setting a state readmissions benchmark and allowing the Health Policy Commission to work directly with hospitals that exceed the benchmark.

Out-of-Network Billing and Behavioral Health 

Health Care For All also testified favorably on a provision which protect consumers from surprise out of network billing and a provision which requires commercial health insurers to cover community and home-based behavioral care for children with mental health conditions.

Senior Health Care

The Massachusetts Senior Action Council also brought up a measure that was not in this legislation, but which they believe should be addressed - high health care costs for seniors. Many seniors in Massachusetts struggle to pay for their medical costs, and often must choose between medical care and other basic necessities. The Massachusetts Senior Action Council testified that 6 in 10 seniors living alone in Massachusetts do not have the income to meet basic needs. The council recommended expanding Medicare savings programs as one way to help lower these costs. While Health Care For All did not testify on this issue, we support efforts to ensure that seniors in Massachusetts are able to afford their health care.

- Sean Connolly