Massachusetts: Lab for Health Reform
The Commonwealth of Massachusetts is, for most observers, the lab for testing innovation in the financing and delivery of care i.e. health reform.
The introduction of Chapter 224, signed by Massachusetts Governor Deval Patrick in August 2012, shifted the risk to providers for cost and quality whereby public purchasers (e.g., Medicaid, the Connector) and private health plans are required to reduce the use of fee-for-service payments and implement alternative payment methodologies in which the provider organization accepts downside risk.
What is unique to Massachusetts is the new regulatory framework it has created to rein in costs and oversee competition in the state’s health care market: the Health Policy Commission (HPC). The HPC’s oversight of spending caps and merger activity, among other areas, is the most sweeping of its kind in the U.S. Naturally, many questions remain to be answered. However, if Massachusetts is successful in its cost-containment mission, the measures included in Chapter 224 may indicate the direction of health policy in other states and at the Federal level.
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