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David Morales, DHCFP Logo

 

 

As we look ahead in this New Year, I thought it would be helpful to share what’s on the horizon for 2011 at the Division:

  • In terms of transparency of quality and costs in health care, 2011 will be an exciting year at the Division.  Our All-Payer Claims Database is moving forward at full speed.  Beginning January 31, health care payers in the Commonwealth are required to submit all health care claims data in Massachusetts to the Division for calendar years 2008, 2009, and 2010.  By the summer, the Division will make data sets available for state agencies to utilize, thereby reducing duplicative data requests from the industry.  In the fall, data files for public use and restricted use will be made available through an application process.
  • 2011 also marks the second year of the Division’s analysis of the factors contributing to the rising costs of health care, as required by Chapter 305 of the Acts of 2008.  The Division will continue to monitor trends in premiums and health care spending and will add a significant new focus on the geographic differences in the volume of services provided and the prices paid for those services.  The analysis will also quantify the extent to which patients travel outside of their communities to receive routine inpatient and outpatient care and the cost and quality impact of those choices.

  • During 2011, the Division will also devote a significant amount of time to other important initiatives required by Chapter 288 of the Acts of 2010.  Such initiatives include the creation of methodologies and the adoption of regulations related to total medical expenses, relative prices, and hospital cost reporting.  These regulations will help us better understand medical expenses, prices paid to health care providers, and improve hospital cost reporting.  We plan to release a report of our findings later this year.
  • As required by Section 64 of Chapter 288, the Division will provide technical assistance on bundled payment initiatives, including publishing a series of technical reports on existing methodologies for bundling.  We will also convene a panel of experts and practitioners to publicly discuss the merits, challenges, and uses of bundled payment methods in the Massachusetts health care delivery system as we transition towards an integrated delivery system that places the patient first.
  • As required by Section 54 of Chapter 288, we will also co-chair the Statewide Advisory Committee on Quality to recommend a standard quality measure set for public reporting of health care quality provided by different health care facilities and medical groups.  Initially, this 8-member committee will select from existing quality measures and propose their adoption though regulations that the Department of Public Health will promulgate.
  • Finally, the Division will also co-chair the Special Commission on Provider Price Reform – as required by Section 67 of Chapter 288 – which was charged with investigating the rising cost of health care insurance and the impact of reimbursement rates paid by health insurers to providers, among other areas.

We will of course inform you of any developments related to our work throughout the year.  As always, I invite you to continue to read our blog, follow us on Twitter, and engage with us on ideas that will improve the health care delivery system and mitigate costs.

Happy 2011.

 

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