A Healthy Blog

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

Private Market

Consumers Groups Push for Strong Transparency Provisions in Health Care Bill

Health Care For All, along with MassPIRG, Health Law Advocates, Community Catalyst and the Massachusetts Senior Action Council recently wrote a letter on the issue of drug transparency to the conferees meeting to work out a final health care bill. We urged the Conference Committee to include strong transparency measures to help tackle the problem of skyrocketing prescription drug prices. Prescription drug costs are currently the fastest growing healthcare expense – by far. For both public and private plans, increases in pharmacy costs far outpace every other expense. Rising drug prices are... Read more »

HCFA Recommendations to Health Care Bill Conference Committee

With both the House and Senate having passed ambitious health care bills this session, now a joint House-Senate conference committee is hammering out the differences to reconcile the two bills for final passage. Health Care For All recently provided comments to the legislature on our recommendations for provisions  to reduce health care costs, protect consumers, and strengthen our state’s health care system. While Massachusetts has the highest insurance coverage rate in the country, there is still progress to be made to improve the quality and affordability of health care in the Commonwealth... Read more »

The HPC wants bold and meaningful change

  The Health Policy Commission (HPC) met on Thursday, May 22 to cover a range of HPC activities including updates on the patient-centered medical home certification program, the registration of provider organization program, and the CHART Phase 2 investments. Slides from the meeting (pdf) have lots of details on the discussion. Keep reading for our detailed summary of the agenda points and discussion. Read more »

Is The Price Right? Now You Can Check. Massachusetts Issues Consumer-Friendly Transparency Guidelines for Health Insurers

Economist Uwe Reinhardt has an apt description of how the complete lack of information around health insurance prices feels to consumers: “Imagine a department store whose customers are blindfolded before entering. A shopper might enter the store seeking to buy an affordable dress shirt and a tie, but exit it with a pair of boxer shorts and a scarf. Sometime later, he would receive an invoice, whose details would be incomprehensible to him, save for one item: a dollar amount in a framed box with the words: “Pay this amount.” Read more »

HPC Committee Hears Testimony on Consumer Appeals Regulation

The Health Policy Commission’s (HPC) Quality Improvement and Patient Protection Committee held a hearing Monday on proposed amendments to 958 CMR 3.000, the Office of Patient Protection (OPP) regulation governing health plan internal and external appeals procedures.  The proposed amendments follow a listening session that OPP convened over the summer, and include consumer-friendly changes required by the Affordable Care Act (ACA) and Massachusetts state laws, as well as changes to provide additional clarifications and protections for consumers. Read more »

HCFA Urges Massachusetts To Reject Extending Non-Compliant Plans (UPDATE: Admin agrees with us)

The Obama administration's decision to permit insurers to continue to offer plans they otherwise would have cancelled (here's some good place-it-in-context background from The New Republic's Jon Cohn) is still subject to state insurance market rules. Already a number of states, including Washington, Arkansas, Vermont and Rhode Island, have ruled that they will continue to insist that all new plans offered in the state comply with the consumer protections in the ACA. Note that "grandfathered" plans, in existence before the ACA was signed in 2010, were always still allowed to be offered to... Read more »

All Your Base Rates Are Belong To Us: Springfield Republican Reports on Premiums Under Obamacare

Yesterday, a story by Shira Schoenberg in the Springfield Republican  covered the just-approved health insurance rates for next year: Read more »

Remember That Dire ACA Forecast? Never Mind.

Remember that dire report commissioned by the Mass Association of Health Plans from July (it's here (pdf))? Never mind. The report was an attempt to forecast the impact of the ACA on small group and individual premiums in Massachusetts. The ominous Globe headline was "National health care overhaul apt to push up costs." The story said: The analysis, by Wakely Consulting Group, projects President Obama’s health care law — supported by the Patrick administration — will tack an average of 3.7 percent on to premiums. Read more »

Interview: Liz Is Happy To Gets Her "Medical Loss Ratio" Rebate From Her Insurer

Under both Massachusetts law and the ACA, insurers must spend a minimum percentage of health care premium revenue on medical benefits for the people they cover. This is called the "Medical Loss Ratio" (MLR) in insurance argot. If insurers don't spend enough of their revenue on medical care, and too much on administrative and other costs, they must pay a rebate of the excess to their customers.  The Massachusetts requirement for last year was that at least 90% of all premiums for individuals and small groups must go for medical care, and no more than 10% can be used for administrative,... Read more »

Consumer Appeal Rights Comments Wanted

The Health Policy Commission’s (HPC) Quality Improvement and Patient Protection Committee convened yesterday. The meeting focused on a discussion of the Office of Patient Protection’s (OPP) internal and external review procedures, and culminated in a lively listening session advising OPP on how to make these processes more accessible to patients and consumers. Read more »

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