Mary Ellen Stahlman
A recent report by the Massachusetts Attorney General, "Examination of Health Care Cost Trends and Cost Drivers," identifies health care cost trends in the commonwealth and explores the key drivers of those trends. The report indicates that payments to health care providers varied widely among major insurers. Further, payment amounts were not correlated with quality, sickness of the patient population, numbers of low-income and Medicare patients treated, hospital teaching status, or the actual cost of providing the services. Instead, payment amounts reflect “market leverage”: the size of the practice or hospital, location, brand name, services offered, or the number of covered lives. Although other research has noted that dominant providers in a market command higher rates, this report uses actual payment data from the state’s major insurers—data never before made public. This Forum session featured a briefing by one of the report’s authors and an exploration of what the findings may mean for payment policy beyond Massachusetts.
Thomas O’Brien, JD, Assistant Attorney General, Health Care Division, Office of the Attorney General, Commonwealth of Massachusetts; Thomas "Tim" Greaney, JD, Chester A. Meyers Professor of Law, Co-Director, Center for Health Law Studies, St. Louis University School of Law; William J. Scanlon, PhD, Consultant, National Health Policy Forum, Former Commissioner, Medicare Payment Advisory Commission
Martha Coakley, "Examination of Health Care Cost Trends and Cost Drivers: Report for Annual Public Hearing," Office of Attorney General, Commonwealth of Massachusetts, March 16, 2010.