Mass. and Minn. officials struggle with controlling health costs, guaranteeing quality

News outlets report that Massachusetts' health reform hasn't adequately addressed the soaring cost of health care, according to the state's Attorney General.

Boston Herald: "Martha Coakley yesterday cautioned that instituting a new payment system won't by itself halt the rapid rise of health-care costs in Massachusetts. Speaking before a gathering of health-insurance executives in Boston, Coakley said the state also needs to curb the negotiating clout of large players within the health-care system who can now dictate prices that could harm smaller players. Coakley said a so-called 'global payment' system, which the state is moving toward as a way to contain costs, simply won't work without other reforms" (Fitzgerald, 11/20).

Boston Globe: "Coakley spoke as the Patrick administration readies a push to overhaul the state's health care payment model by moving toward set payments to doctors and providers based on individual patient care and outcomes, rather than the current fee-for-service model. ... Coakley said the report produced by her office and released in January showed how wide disparities in pricing and reimbursements for procedures and care could not be linked to quality of care."

"She said increasing transparency for consumers around pricing would be the best start to gaining control over market-driven pricing. 'If we seek to better align payment incentives and control cost growth, then we must begin to shift how we purchase health care to align payments with value, measured by those factors the health care market should justly reward, such as better quality and efficiency,' she said" (Murphy 11/20).

Boston Business Journal: Coakley "said that she will launch a second investigation into the relative costs of different delivery systems of care, including teaching hospitals, community health centers, and so-called Accountable Care Organizations, where a primary care physician acts as the hub of a patient's care experience, and specialists act as the spokes of the wheel. A previous report focused on the costs of certain procedures revealed that some hospitals, including the Partners Healthcare system, hold market clout that enables them to charge significantly higher prices for the same services" (Donnelly, 11/19).

Related KHN story: California Hospitals: Prices Rising Rapidly, But Quality Varies (Rau, 10/18)

Meanwhile, Minnesota is also grappling with quality and cost issues, the Minneapolis Star Tribune reports: "The first state-mandated report on quality of medical care in Minnesota shows that clinics and hospitals vary dramatically in how well they treat patients -- even on something as basic as children's colds. ... The report was mandated as part of Minnesota's 2008 health reform law and produced by the Department of Health, in an effort to place more information in consumers' hands. ... 'When consumers are armed with information about their health care, they will make better choices,' Gov. Tim Pawlenty said in a statement" (Lerner, 11/18). 

(St. Paul) Pioneer Press: "State officials say that the significance of Thursday's release is that it sets the stage for future scorecards that will evaluate clinics and hospitals in terms not just of quality but also cost. Those future reports will allow for state officials to group health care providers with their cost and quality peers. The 2008 health care law that called for the creation of the reports also asks public health insurance programs in the state and some private health plans to create health insurance products that include incentives for consumers to opt for doctors and hospitals in the high-quality, low-cost 'peer group'" (Snowbeck, 11/18).