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David_morales Posted by: David Morales, Commissioner, Division of Health Care Finance and Policy

Next week, we will bring together key stakeholders from the Massachusetts health care system at a series of public hearings related to health care provider and payer costs and cost trends. Our goal for these hearings is to engage in an honest and in-depth dialogue to shed light on the factors contributing to the unsustainable level of growth in the Commonwealth’s health care spending.

There are two key questions to be discussed by those in attendance, including providers, payers, policy-makers employers, consumers, and the public: why are costs rising at the rate they are, and what do we do about it? The urgency to answer these questions is very real as access to health care, the vibrancy of our economy, and the sustainability of our state’s landmark health reform are at stake!

In recent months, both Massachusetts and the nation have been struggling to determine the most effective and plausible paths forward on addressing rising health care costs. Many thoughtful ideas and strategies have been offered, ranging from a gradual redesign of the delivery system to move towards Accountable Care Organizations (ACOs), to payment reform, to provider and insurer rate review, to revisions of regulations of the health insurance market.

Some other states have experiences whose lessons we might draw from during the hearings, such as California, which recently received national attention for Anthem Blue Cross’ nearly 40% rate increases for subscribers in the individual market. A recent Health Affairs article outlined key challenges facing California given some of the unintended consequences of providers banding together in larger systems for price negotiations, some of which are similar to the challenges in the Massachusetts market. The article goes on to recommend that direct regulatory intervention be considered. These hearings provide an unprecedented, but timely, opportunity for these ideas to be debated in the light of day, with the input of key players and in the spotlight of the public’s attention.

Against the backdrop of these state-wide and national policy conversations, the key issues that we will discuss during the hearings are:

The Experience of Consumers and Employers: Attendees will hear from employers – large and small – about how the rising costs of health care are affecting their ability to hire new workers, keep the ones they have, or provide wage increases. Consumer advocates will talk about the impact of the current health care cost trajectory on access and financial stability for Massachusetts families.

Dynamics and Opportunities for Improvement in the Health Care Delivery System: Testimony and dialogue will explore market dynamics, incentives for coordination of care, preventable hospitalizations, medical homes, and how our system can better integrate and promote effective preventative services. 

Cost Drivers in the Health Care System: Health policy experts and witnesses will be led in an in-depth discussion of the key drivers of rising health care costs, such as price vs. utilization, price variation between providers, models for reforming the way providers are paid, transparency of costs and quality data, and the role of medical technology.

Policy Solutions: Experts and panelists will discuss the feasibility of various strategies for mitigating health care cost growth –from both a policy and industry perspective.

The hearings are open to the public and will be held on Tuesday, March 16; Thursday, March 18; and Friday, March 19, 2010 starting at 9:00 AM at the Joseph P. Healey Library University Club, 11th floor, University of Massachusetts Boston.

For more information on the hearings including the full agenda and witness testimony, please visit And, for updates related to the hearings, please follow the Division of Health Care Finance and Policy on Twitter at

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