A Healthy Blog

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

Mazel Tov, Stuart

Mazel Tov, Stuart

November 2, 2012

Stuart Altman speaking at HCFA book event 7-22-11

The Patrick administration announced today that Brandeis University health economist Stuart Altman will chair the Health Policy Commission (HPC), the central new policymaker under the Chapter 224, the cost containment law (press release). As expected, the appointment of DHCFP Commissioner Áron Boros to head the Center for Health Information and Analysis, or CHIA, was also announced today (don't worry, Áron already has a chia pet in his office).

Altman is renowned for his work on federal health policy, from his work running the Nixon administration's health cost containment policy, to his 12 years (1984-96) chairing the Prospective Payment Assessment Commission which advised on Medicare payment policy, to his work on the Clinton and Obama health care plans. His long experience led to a book detailing the history of US efforts to reform health care.

But he has also been close to state health policy. From 2000 to 2004 he chaired the state's "Government/Legislative Health Care Task Force," called the "Blue Ribbon Commission," that brought together all state health care stakeholders to look closely at state health policy. He was consulted by all parties in the run-up to chapter 224.

Altman has been a long-time friend of HCFA, and understands the role consumers must play as we reform health care delivery and payment structures. In an interview with WBUR's Commonhealth blog, he emphasized the need for consumer involvement and patient education:

... I think patients need to be part of this equation and we need to be balancing their needs with the people that pay the bills, so that’s one side.

...I don’t think patients really understand these limited networks and tiered networks and ACOs and the like. I think there needs to be an expanded consumer education program. Also I think we need to do it smarter and I think tiered networks that are a better model than limited networks, in the sense that you don’t force a patient into any one delivery system, you just make it more expensive if they jump out of one to the other, which continues to gives them the choice. What happened in the ‘90s is that often they had no choice, they had to be at a particular network and they couldn’t jump out.

So I think we’ve learned something in the last 20 years. If we’re going to ask organizations to have responsibility for total spending of a particular patient population, [the patients] need to know they’re in a particular group, but they also need to have the flexibility if for some reason they want to get out. I think we need to better educate our consumers and patients, but I think we’ve also learned from the ‘90s, so I’m hopeful.

We welcome Altman's appointment. The other 10 members of the HPC Board should be appointed in the next few weeks, leading up to their inaugural meeting on November 16 (Gardner Auditorium, 9:30 to noon; other details will be posted on the state's Chapter 224 implementation website).
-Brian Rosman
(Full Disclosure: I worked for Altman at Brandeis from 1998-2003)