Health association testifies to state board on regulations
An organization representing health care plans was alone in responding publicly Wednesday to proposed regulations governing how a state agency deals with health care providers and payers who are deemed to have "excessive" annual cost increases.
Only the Massachusetts Association of Health Plans testified Wednesday at the public hearing held by the Health Policy Commission's Cost Trends and Market Performance Committee, and the committee chair suggested the regulations could be finalized in two weeks.
A portion of the 2012 health cost containment law kicked in last year authorizing the commission to require performance improvement plans for payers and providers whose excessive cost growth is deemed to threaten the state's overall benchmark.
"The performance improvement plans process is one of the key mechanisms in Chapter 224 by which the HPC can enforce the benchmark and ensure accountability to the commonwealth's cost containment goals," HPC Executive Director David Seltz said.
He added, "We really think about the performance improvement plans as an opportunity for the HPC to work with payers and providers to address their cost growth and to pursue collaborative best strategies to address them, and really is an opportunity for the commission to help move our cost containment goals forward."
The performance improvement plan (PIP) process begins when the Center for Health Information and Analysis provides the HPC with a confidential list, typically each fall, of entities that experienced excessive cost growth. The HPC board then can vote to require an entity on that list to submit a proposed PIP within 45 days. Implementation of the PIP begins immediately upon the board's vote to approve the plan and a PIP can remain in effect for up to 18 months, according to the HPC.
Medical spending in Massachusetts for two straight years has exceeded the 3.6 percent benchmark established under the 2012 law intended to control costs.
Total health care spending in Massachusetts increased 4.1 percent in 2015 to $57.4 billion after climbing 4.2 percent in 2014, according to CHIA. There are no penalties associated with exceeding the benchmark. The HPC plans to vote March 29 on whether to set the growth benchmark at 3.1 percent, 3.6 percent or somewhere in between.
Working under interim guidance for about the last year, the HPC and its committees have been putting together permanent regulations governing the performance improvement plan process. Wednesday's public hearing was the final step before the HPC board could be asked to approve the regulations.
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