Chapter 288 of the Acts of 2010 directed several state agencies and created commissions to study and report back on certain aspects of the Massachusetts health care system and, in some instances, provide recommendations for further action. Descriptions of the reports and links can be found below.
Recommendations of the Special Commission on Provider Price Reform
Pursuant to Section 67 of Chapter 288, the Special Commission on Provider Price Reform was formed to discuss ways in which health care providers and private insurance companies should determine a provider’s price tag. These discussions were a part of the Commonwealth’s broader efforts to contain health care costs and improve quality. The Special Commission examined a number of presentations from the Division of Health Care Finance and Policy and the Office of the Attorney General that showed a wide variation in provider prices and the impact these prices have had on the rising trend in health care spending in Massachusetts. The Special Commission concluded in November 2011 with recommendations to the Commonwealth.
Total Medical Expense Baseline report
To increase cost transparency in the health care system, and to provide a mechanism for financial data and monitoring analysis, Section 51 of Chapter 288 directed the Division of Health Care Finance and Policy to annually collect data from health insurers and publish corresponding Total Medical Expense (TME) reports detailing the total cost of care for the entire population that each health insurer covers. The 2009 TME Baseline report is the first annual report published under this mandate. Key findings indicate that there is significant variation in health care spending among payers, and TME varies considerably based on geographic area.
Report on the Impact of Consumer Choice in the Individual and Small Business Market
Section 58 of Chapter 288 directed the Division of Insurance to study the impact of consumer choice on the availability of multiple health plan options in the individual and business marketplace. The goal of the study was to determine how many insurance product options should be available to an individual or employer at any given time so that the consumer has sufficient product choice but does not become overwhelmed with options or choose a plan with insufficient benefits. The study also examined how reducing the number of health plans available might help lower administrative expenses for insurers and health care providers.
Report on Bundled Payments
To help promote cost savings in the health care system, Section 64 of Chapter 288 directed the Division of Health Care Finance and Policy to publish a report on the concept of bundled payments as an alternative payment arrangement to fee-for-service. As explained in the report, a bundled payment is a single payment that covers an episode of care for a patient with a certain condition. Payers can enter into payment arrangements with health care providers within integrated systems to receive bundled payments as a reward for teamwork while providing an incentive to avoid costly duplicative procedures that often occur in fee-for-service payment arrangements. In addition to a providing a description of bundled payments, the report outlines operational and design issues that are essential for health care payers and providers to develop bundled payment arrangements.
Skip to main content
