April 2010

April 30, 2010

The Greater Boston Aligning Forces for Quality (GBAF4Q) alliance announced this week that is has been selected by The Robert Wood Johnson Foundation to participate in Aligning Forces for Quality (AF4Q), an unprecedented effort to lift the quality of health care provided in select communities nationwide.

GBAF4Q is a multi-stakeholder collaborative led by Massachusetts Health Quality Partners and the Eastern Massachusetts Healthcare Initiative and is supported by more than 35 Boston-area organizations, including Health Care For All. The Boston initiative joins 16 other regions to improve the quality of health care at hospitals and in doctors’ offices, reduce racial and ethnic disparities in care, and provide models for implementing national reform.

The work will be grounded on the core principle that to transform the health care system, everyone who gives care, gets care and pays for care must work together. GBAF4Q will focus on four key areas:

  1. Performance measurement and public reporting: using common standards to measure the quality of care that doctors and hospitals deliver to patients and making that information available to the public.
  2. Consumer engagement: encouraging patients to be active managers of their health care, and make informed choices about their doctors and hospitals.
  3. Quality improvement: implementing techniques and protocols that doctors, nurses and staff in hospitals and clinics can follow to raise the level of care they deliver to patients.
  4. Health Equity: reducing disparities in care for patients of difference races and ethnicities.

Specifically, GBAF4Q will center its work on reducing preventable emergency department visits and associated admissions. Although health care is a national problem, health care is delivered locally, and fixing it requires local action. GBAF4Q hopes to mobilize teams of stakeholders representing the people who get care, give care, and pay for care to rebuild our health care system so it works better for everyone involved.
-Mehreen Butt

April 30, 2010

Earlier this week, the Massachusetts Medicaid Policy Institute released a superb report, “Enrollment and Disenrollment in MassHealth and Commonwealth Care.” Bob Seifert, from the UMass Center for Health Law and Economics is the lead author. Bob's Commonhealth blog post does a good job of summarizing, as does the report’s executive summary.

Bottom line: "A sizable number of people are unable to maintain their coverage over a period of time, despite remaining eligible for the program....The consequences for those who encounter even a temporary loss of their health insurance coverage are extensive, significant, and often detrimental."

For those of us who work with MassHealth and Commonwealth Care, the report tells us what we know – just with real numbers and excellent detail. Lots of folks fall off of coverage and fall off often; gaps in coverage are expensive and negatively impact health status; and much of the “churn” that occurs for administrative reasons can be prevented.

We hear from thousands of confused and frustrated HelpLine callers every year that are affected by churn. Folks often times call us after they have show up for their doctor’s visit or go to pick up a prescription and are told that they are uncovered. It can take weeks for these glitches to be resolved. In situations like these, people are usually required to pay out-of-pocket for their care. This leaves the family unable to access the health care services that they depend on until they sort out the mix-up.

Bob analyzed data from both health programs for 2008 and 2009, looking to understand how many people are disenrolled and then re-enrolled in a program within three months. If there is churn in this 90 day window, it’s likely that the disenrollment was caused by an error (on either the State’s or the enrollee’s side), not a status or eligibility change. On average, over 12,000 people per month fall into this category – at a admin cost to the state of $200 per enrollee, per enrollment cycle. That’s $28,800,000. (In case you’re stumped, we have some thoughts on what we could do with that money.)

Now some of this disenrollment and enrollment will always happen—people get lost, don’t do what they’re supposed to. The Feds make demands of the state requiring eligibility checks. But there are also plenty of pieces of churn that are avoidable and that we should fix, on both the MassHealth and the Commonwealth Care sides of things. What kind of churning we can eliminate through administrative fixes? How can we reduce volatility in the MassHealth and Commonwealth Care caseloads?

Here’s what’s exciting; MassHealth is working hard on some fixes to the problems. The report talks about the state’s grant from the Robert Wood Johnson Foundation, “Maximizing Enrollment for Kids,” that focuses on improving administrative processes and improving retention. Through the grant, MassHealth’s Chief Operating Officer Phil Poley conducted a diagnostic assessment of their data use, capacity, and customer service and found areas of improvement to focus on:

  • Administrative renewals (pre-printed forms that require a response only if there is a change in eligibility): MassHealth has already started this with some nursing home patients (see our blog post) and is now trying to understand what other populations they could expand to.
  • Ex-parte renewals (fancy way of saying using other sources of information – DOR, Food Stamps – to make determinations): this promotes collaboration between various state agencies, saving time, money, and personnel resources.
  • Centralized electronic document management (EDM, your new acronym of the day): a chunk of enrollment volatility is due to misplaced or delayed forms. MassHealth is starting an EDM pilot later this year that they plan to expand into next year.
  • 12-month continuous eligibility: the state is looking for financial models to understand better what this would look like.

MassHealth will be hosting its first annual statewide stakeholder meeting on June 10th, at the UMass’ Hoagland-Pincus Conference Center, for walk through the grant, explanation of the diagnostic assessment, and discussion. (Invitations out through MTF soon.)

Two policy pieces that Health Care For All, the ACT!! Coalition and the Children's Health Access Coalition (CHAC) have been working on will prevent additional churn and gaps in coverage. ACT!! would like to see Commonwealth Care use the MassHealth model of starting enrollment on the date of application,as called for in our bill now pending before the Health Care Financing Committee (see fact sheet).

And CHAC is focusing on 12-month eligibility for kids, an option encouraged by federal law but not implemented in Massachusetts. Last night, the House approved a budget amendment by Rep. Ellen Story establishing 12-month eligibility. This is good for families, for providers who won't have to worry about patients cycling on and off, and for the state, through lower administrative costs. We thank Rep. Story for her outstanding advocacy and look for a similar provision in the Senate.

April 29, 2010

Asthma is the leading cause of emergency room visits and hospitalizations for children covered by Medicaid. The majority of these are preventable and now we are one step closer to a substantial reduction in these incidents. On Tuesday the House approved a budget amendment that will help providers and families better manage pediatric asthma.

The amendment directs the Office of Medicaid to establish a global payment program for high-risk pediatric patients enrolled in MassHealth. This approach will be piloted in communities with high rates of uncontrolled childhood asthma. The program will be specifically designed to prevent unnecessary hospital admissions and emergency room utilization. As stated in the amendment language, the global payment structure will encourage management tools such as “patient education, environmental assessments, mitigation of asthma triggers, and purchase of necessary durable medical equipment.”

The amendment can be seen as pilot of our payment reform proposal. The online magazine Slate asked today, "Why do insurers ignore the most promising way of cutting health costs?" The article describes the experience of Children's Hospital Boston in empowering families to work on controlling asthma:

Last November, researchers from Children's Hospital Boston reported interim results from a community-based asthma program that used case managers, home health aides, and outreach to coordinate the proper steps for children with severe asthma. Within six months, emergency-room visits dropped by 60 percent. Hospitalizations fell by 80 percent and stayed down for a year. And yet, according to a legislative liaison from the hospital, "in the current traditional health care system, these kinds of workers"—such as home-visiting nurses and case managers—"are not providers that have been able to bill or get any payment for their services."

Why don't doctors do a better job of matching the right patients with the right procedures for treatable problems like asthma? Observers tend to blame this mess on our "fee-for-service" payment system. The more doctors do, the more they are paid; rather than rewarding quality, insurers pay for quantity. If a hospital's doctors do a terrible job, necessitating longer and more frequent hospitalizations for a child, they get rewarded with more money. That's why many reformers believe the solution is to "bundle" payments: Insurers would pay a fixed, up-front cost for each particular health problem—like asthma—and let the hospital and caregivers determine the best way to use the money to deliver quality care. Bundling could save money, improve care, and encourage innovation by health providers.

In addition to improvements in prevention and quality of care, the global payment program is expected to reduce costs and pay for itself within two years.
-Criselda Ruiz

April 27, 2010

The Campaign for Addiction Prevention, Treatment, and Recovery, a broad coalition of organizations working on substance abuse and related issues, is working hard to urge House members to vote no today on amendment 43, which would repeal last year's statute removing the the sales tax exemption on alcohol.

The vote is expected Tuesday morning or early afternoon. Call your Representative now!

[UPDATE: The House defeated the amendment on a 67-82 vote. We thank those legislators who supported public health and voted against the amendment.]

The campaign has released a detailed fact sheet explaining why this is critical for Commonwealth, and good policy:

Revenue raised from the alcohol tax produces over $100 million dollars in dedicated funding for substance abuse prevention, treatment and recovery services. Repealing the alcohol sales tax is unfair. This will increase underage drinking and hurt families.

The state’s alcohol tax at retail sale is mainstream

  • 45 states have a sales tax on alcohol purchased in stores
  • 45 states have a sales tax and an excise tax on alcohol
  • New Hampshire’s excise tax on beer is 3 times that of Massachusetts
  • Even with the sales tax, alcohol is cheaper here than in Rhode Island, Connecticut, Vermont and Maine and is one of the lowest in the northeast
  • In a 2009 poll, nearly 60% of adults in Massachusetts supported increasing alcohol taxes - if the funds are dedicated to substance abuse treatment and prevention programs.

Repealing the alcohol tax will increase underage drinking

  • A Department of Public Health study found that Massachusetts has one of the highest rates of teen drinking in the country, with 40% of those ages 12 to 20 using alcohol. Removing this tax would lead to more teen drinking.
  • Research finds using taxes to raise prices on alcohol is a among the most effective determent to underage drinking

Repealing the alcohol tax will hurt families

  • Massachusetts has some of the highest rates of alcohol and drug abuse in the county—the last thing we need is to take money away from prevention and treatment services in order to make alcohol cheaper. Repealing the alcohol tax would result in severe cuts in services to over 100,000 people each year who are struggling with addictions and substance abuse problems.
  • The alcohol tax saves Massachusetts money by preventing and treating substance abuse problems so people can turn their lives around before they end up in prison.
  • Repealing the alcohol sales tax would literally cost lives. Underage drinking kills 4 times as many young people as all drugs combined. Repealing this tax would put more alcohol in the hands of teenagers.
April 27, 2010

Around 7:30PM on Monday the House began their week of budget debate. Chairman Murphy began by giving an overview of the budget world. The good news, the nation is on the road to recovery. The bad news, unemployment in the state is still over 9% and the state’s tax receipts are still below expectations. Massachusetts is not out of the woods yet. Chairman Murphy was tasked with filling a $3.2 billion deficit. Luckily, the FY11 budget includes $1.6 billion in federal stimulus money. The HWM budget included $800 million in line item cuts and about $234 million dollars in savings by cutting local aid. The HWM budget included no new tax increases, and no use of rainy day funds. According to Chairman Murphy, his budget is “balanced, but not terribly pretty.”

First up on the debate, the 24 revenue-related budget amendments. HCFA supports a number of various revenue initiatives. Chairman Kaufman, House Chair of the Committee on Revenue, committed to looking comprehensively at the tax expenditure budget in the coming year.

The big debate centered on an amendment to repeal of last session’s removal of the sales tax exemption on alcohol. Repeal would cost the state some $100 million in revenue. A referendum on the ballot for Nov. 2nd will have a similar question. Rep. Kulik, Vice-Chairman of the House Ways and Means Committee opposed the amendment and stated, let the voters decide in November.

The House finished for the night just before 9:00, without voting on the alcohol sales tax amendment, amid speculation that the amendment may have sufficient votes to pass. HCFA urges House members to reject the amendment. Sessions resume at 10 am, and we would urge people to call their Representatives first thing Tuesday morning and ask for a vote in opposition to the alcohol amendment.

What’s in store for rest of the week? About 800 more budget amendments. The House has posted a list of budget amendments categorized by subject (pdf).

Final aside, money well spent a few years ago to streamline the live webcast of all debates, at www.masslegislature.tv.
-Mehreen Butt

April 27, 2010

Massachusetts has an important opportunity to advance health equity through legislation pending in the Health Care Financing Committee. Filed by Senator Fargo and Representative Rushing, S. 810 (An Act to Eliminate Racial and Ethnic Health Disparities), establishes a permanent Executive level Office of Health Equity that works to address the root causes of health inequality.

The Office will oversee a statewide disparities agenda by coordinating the activities of both health and non health agencies to create healthier more equitable communities. As health disparities result from a complex set of factors related to environment, education, employment and other social issues; this Office provides the coordinated strategy that is necessary to ensure all populations have equal opportunities for good health.

Everyone suffers when there is health inequality. Lost health care dollars, reduced economic vitality of the state’s residents, and indirect social costs all result from the excess death and disease suffered by too many in the Commonwealth. Moving forward S. 810 is one sensible way for the state to work towards reducing these costs by supporting health equity.
-Camille Watson

April 26, 2010

Massachusetts should ban prescription drug data mining. This week, the Joint Committee on Health Care Financing has the opportunity to get us one step closer to that ban. S. 17/H. 109 will prevent pharmaceutical companies from buying doctors’ prescribing records from pharmacies and using that information to target their marketing to physicians (check out this video for an explanation).

As the US District Court said: “[c]oincident with the phenomenon of ‘data mining,’ pharmaceutical industry spending on direct marketing has increased exponentially.” The pharmaceutical industry spends approximately $30 billion (that’s more than the state’s annual budget) a year to promote its drugs. It spends about half of that developing new drugs and treatments. Why does it spend this kind of money? Because it works. Data mining can boost overall drug profits 3 percentage points and sales of new-to-market drugs by 30%.

The detailers walk into doctors’ offices with the doctor’s profiles in hand to fine tune their message. Detailers rely on this information and find it critical to ‘making the sale’. The companies spend money now on marketing because they get a huge return on their investment. The ban on data mining will change that. By banning data mining, we remove the ability of industry detailers to be so targeted in their pitch. The sales detailers will be forced to be more generic and objective in the information they present to prescribers because they will no longer have access to our data-mined information. The result is that there will be less prescribing of new, costly drugs and better treatment for patients. Vermont and New Hampshire predict their bans will produce savings of 1% or more off of their drug costs- not too shabby when we are looking at any way to cut health care costs.

The right care at the right price- good for patients and good for the state.
-Georgia J. Maheras

April 26, 2010

Unfortunately, a tight budget has become par for the course in recent years. This week, as part of the annual rite of spring that is the House Budget Debate, legislators will have to make difficult decisions about what and how much spending to cut in Fiscal Year 2011.

In this fiscal climate, it’s hard for legislators to look beyond the next revenue projections. Still, as advocates and citizens, it is our responsibility to call on them to see the big picture.

Example: This article from Sunday’s Boston Globe Magazine.

Yes, providing mental health consultative services to pre-school children costs money.

But not spending this money today will cost the Commonwealth even more in increased Special Education costs in the future.

And if the money argument wasn’t enough, take a look at what the parents of these children have to say about their children in the article. The help they got turned their kids around.

Mental health services for young children should be a legislative and budgetary slam dunk: it saves money and helps kids. But in this economic environment? Nothing is for sure.

Legislators need to be aware of this program and the others like it. The Children’s Mental Health Campaign plans to spend from now until the end of the FY 2011 Budget process making sure that that happens.
-Matt Noyes

April 26, 2010

In the past four years, health reform has expanded health care access to over 400,000 Massachusetts residents. At 97.4%, Massachusetts has the highest rate of insurance coverage in the nation. With increased access to health insurance, health outcomes are beginning to improve.

Two key legislative priorities of the ACT!! Coalition are currently before the Joint Committee on Health Care Financing. These bills would strengthen health reform’s success. We urge the Committee to report these bills favorably.

Despite Massachusetts health reform’s success, gaps in coverage still exist, affecting people’s ability to access critical health care services. An Act Strengthening Health Reform (S.873/H.4258) seeks to secure health care access and continuity of coverage for Massachusetts residents. One of the provisions in the bill – prohibiting lifetime caps in all health insurance plans – has been accomplished through national health reform.

The bill also would address gaps in coverage caused by current application and appeals processes. It would require Commonwealth Care enrollment to begin on the date of application (instead of the first of the next month) and provide retroactive coverage for wrongfully terminated members. This bill would also make Health Safety Net retroactive coverage consistent at 6 months for all eligible patients, in order to ensure providers get the reimbursement they need and patients not go into bad debt due to a timing difficulty.

Two provisions of An Act Strengthening Health Reform would strengthen our system with no cost to the state:

  • Give the Office of Medicaid the flexibility to provide cost-effective care to elderly and disabled legal immigrants: Without access to post-acute services, many MassHealth Essential members become “stuck” in the hospital for longer than necessary. This provision gives the Office of Medicaid the flexibility to authorize additional benefits – like home care and skilled nursing – when it is cost effective.
  • Codify and strengthen the MassHealth Outreach Grant program: The MassHealth Outreach Grant program is a critical part of health reform’s success. Without continued expert assistance over time, the gains of health reform will be lost as individuals are unnecessarily terminated from programs and lose access to primary and preventive care. This provision would make the MassHealth Outreach Grant program permanent.

The second ACT!! bill, An Act Relative to Health Care Affordability (S.549/H.1102), seeks to address cost on the individual and systematic levels by

  • Redefining affordability to include out-of-pocket costs; and
  • Creating a separate Division of Health Insurance to improve public accountability and transparency of health insurers.

The Affordability Schedule change will have the most immediate impact for health consumers, at no cost to the state. By reworking the Affordability Schedule to take into account all out of pocket costs, not just premiums, consumers will be better protected from unaffordable health coverage. We all know that the cost of health care doesn’t stop at premiums; most of us also have co-pays, and some have deductibles and co-insurance. So, why shouldn’t the Affordability Schedule also take these costs into account?

We ask the Joint Committee on Health Care Financing to look at these bills with an eye towards the impact they will have on Massachusetts residents’ ability to access affordable, quality health coverage.

If you have any questions about these bills, please contact Suzanne Curry at scurry@hcfama.org.
-Suzanne Curry

April 25, 2010

In our last blog post, we detailed a number of the budget amendments HCFA supports. Most of the amendments would add spending to the budget. We also support a number of proposals that would add spending that are not being actively considered for next year's budget, like re-integrating legal immigrants into Commonwealth Care, or rebuilding our tobacco control and other public health programs that have been drastically cut over the past 5 years.

Which leads to the legitimate question - how can the state afford to increase spending on these health programs?

For one, we think there are number of real, immediate savings that can be found in the state's health budget that would save costs and improve care. For example, other states are beginning to reduce payments to hospitals with high rates of preventable complications. This flips the current incentives, where hospitals can earn more revenue from poorly coordinated care. This step is an important precursor to global payments, which has the potential to reduce spending further.

But second, HCFA strongly endorses a number of revenue initiatives (that means tax increases) to rebuild our public systems that provide the quality of life we want for every Bay Stater. HCFA is a member of the One Massachusetts community campaign, "Investing in our Commonwealth." The campaign, which includes groups such as the Mass Teachers Association, Coalition for Social Justice, Mass Home Care, Mass. Senior Action Council, and Mass Public Health Association, is working for a fair tax system that protects what we value in our state and provides the resources needed to invest in the public good.

Monday morning at 11:30, HCFA will be joining with other groups outside the House Chamber as the House begins its budget debate. We will call on the House to approve a number of revenue proposals that have been filed as budget amendments:

  • Rep Hecht's amendment #287 to plug the loopholes in our tobacco tax. Although the state raised taxes on cigarettes in 2008, it's been nine years since prices on inexpensive, kid-friendly other tobacco products (OTP) such as flavored small cigars and smokeless tobacco have been addressed. While cigarette smoking has declined nationally in part because of tax increases, OTP sales have increased rapidly, especially among youth. The amendment would increase the excise tax on these products to match the cigarette rate. See this fact sheet from Tobacco Free Mass.
  • Rep. Patrick's amendment #329 to remove the exemption from the sales tax from candy and sweetened soft drinks. This proposal, also strongly supported by Governor Patrick, will discourage consumption of unhealthy snacks and soft drinks, particularly by children who are subject to aggressive marketing campaigns. The amendment earmarks the revenue for critical public health programs, including health promotion, school-based health programs, teenage pregnancy prevention, domestic violence and sexual assault prevention. Forty other states already tax sweetened beverages and/or snack food. See this fact sheet for more information.
  • Rep. Patrick's amendment #323 to restore the tax rate on interest and dividends to 12%.The amendment exempts the first $5000 of interest and dividend income for seniors. The reduction in the tax rate from 12% to 5.3% on interest and dividend income brought large rewards to the highest-earning residents. Data from the Institute on Taxation and Economic Policy shows that the top 1% of earners in 2008, those earning over $562,500, saved on average $10,057 due to this tax cut. The bottom 80% of taxpayers saved less than $100 on average (source, see fig. 3). Going back to the pre-existing rate would raise hundreds of millions of dollars and re-orient our tax system more towards assessing individuals based on their ability to pay.

HCFA urges people to contact their representatives in support of these revenue proposals (sample phone script), and join us in working with One Massachusetts for fair, adequate revenue. Use this sign up form to be kept informed on the campaign.
-Brian Rosman

April 25, 2010

This week the House begins debate on its version of FY 2011 budget (see the just-issued in-depth analysis by the Mass Budget and Policy Center). Representatives have proposed over 800 amendments (full list and summaries), which will be considered over the week. Based on past practices, we expect most of the amendments to be dealt with as part of a consolidated amendment concerning health issues, with a few pulled out for individual debate.

The amendments include important proposals to provide adequate resources for vital health programs and maintain critical policy initiatives. Others would reverse progress and harm overall health. Below are our comments on a number of key amendments HCFA supports and opposes.

The list below does not include revenue amendments, which will be covered in another post.

We strongly urge everyone to call your Representatives and share your thoughts on these amendments.

SUPPORT:
Preserve Oral Health Benefits – Amendment #547, filed by Rep. Scibak, protects MassHealth adult dental benefits. The HWM budget authorizes the elimination of many dental benefits which would affect nearly 700,000 people in Massachusetts, including over 100,000 seniors. Eliminating dental coverage results in more spending for costly services in emergency and inpatient hospital settings due to dental infections. The long-term cost of eliminating adult dental care is 2.5 times more than the cost of providing care.

Strengthen Commonwealth Care Bridge Program – Amendment #507, filed by Rep. Cabral, stops cuts to the Bridge program for legal immigrants. The House budget recommends funding the Commonwealth Care Bridge program, the reduced-benefit plan for legal immigrants, at $60 million. The language closes the program at its current membership, locking out over 13,000 eligible people. Rep. Cabral’s amendment would increase funding to $75 million and remove the cap on the program.

Protect DPH Quality Initiatives – Amendments #169 and #170, filed by Rep. Provost, fund critical health protection programs. DPH’s Division of Health Care Quality and Infection Prevention and Control Program both do great work that continues the progress Massachusetts has made in health care cost, transparency and safety. The amendments increase funding for these divisions so they can continue protecting consumers.

Reduce Health Disparities – Amendment #495, filed by Rep. Rushing, adds language to the budget to create an Office of Health Equity in EOHHS. The office would be tasked with preparing an annual health disparities report card with regional disparities data, evaluating effectiveness of interventions, and replicating successful programs across the state.

Restore Prescription Advantage Benefits – Amendment #293, filed by Rep. Allen, and Amendment #571, filed by Rep. Hogan, increase funds for the Prescription Advantage program, which assists low-income elderly and some disabled individuals facing unaffordable prescription costs. The program has been cut dramatically over the past years. Also, Amendment 480, filed by Rep. Fernandes, insures that programmatic cost savings will be put back into the program to restore benefits that were cut earlier.

Reduce Drug Costs and Improve Care – Amendment #574, filed by Rep. Grant, restores funding for the state-sponsored evidence-based outreach and education program, often called “academic detailing.” This program provides health care providers with balanced information about the effectiveness, safety and costs of all prescription drugs on which they can base their prescribing decisions. Our friends at The Prescription Project blogged this week on how valuable objective information is, emphasizing that these programs save costs and improve clinical care.

Enforce Pharma Marketing Rules – Amendment #576, filed by Rep. Grant, restores needed funding so the pharmaceutical and medical device marketing oversight program can comply with implementation requirements. The program includes data collection and a comprehensive, consumer-friendly website that will show how much money the pharmaceutical and medical device industries are spending on prescribers in Massachusetts. This program gives Massachusetts patients and consumers the opportunity to follow the money and make safe and informed treatment decisions with their clinician.

OPPOSE:
Raise Insurance Premiums – Amendments #153 (James M. Murphy) and #791 (Steven M. Walsh) would allow some small businesses to exit the small group insurance market and form their own pool. By breaking up the broad group market, these amendments will do nothing to reduce premiums for small businesses and will hurt more than they will help. They undermine important insurance reforms implemented by the Legislature over the last two decades to guarantee availability and renewability of health coverage and the creation of broad insurance rating pools. The result would be higher health insurance premiums for the vast majority of small businesses.

April 25, 2010

The DOI will hold two informational hearings in the next few weeks. The first hearing, scheduled for May 6th at 10 am, will discuss limited provider networks and the effect they may have on small business health insurance premiums. Both the Governor's and the Senate President's premium rate relief bills direct insurers to offer limited network plans.

The second hearing, scheduled for May 7th at 10 am, will discuss the benefits of transparency in the health care marketplace. The DOI's notice explains the goal:

"The purpose of the Informational Hearing on Transparency is to afford all interested persons an opportunity to provide oral and/or written comments regarding the benefits of transparency and its effect on competition in the health care marketplace. Specifically, the Division is seeking comments on ways to promote transparency, including insurers’ public disclosure of certain cost information related to specific procedures.

With the beginnings of transparency of information revealed by the Attorney General's report on the state's health marketplace, this hearing should move the ball further towards greater public accountability within our health care financing system.

Both hearings will take place at 1000 Washington Street, Suite 810, Boston, Massachusetts, 02118. Anyone wishing to testify should contact the Docket Clerk at DOI.
-Georgia Maheras

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