Yesterday the Chairs and Ranking Members of the Insurance Committee convened a forum on potential reforms to lower healthcare costs. Legislators invited David Seltz from the Massachusetts Health Policy Commission. Connecticut speakers included representatives from the insurance industry, providers, state officials, a foundation and advocates. A recurring theme was the need to re-build trust among stakeholders and engage all voices in reforms. There was a great deal of agreement among speakers, which seemed to surprise everyone. Reforms considered included a state 1332 wavier for reinsurance to lower premiums, creating a health care cost growth benchmark, and importing prescription drugs.
David Seltz described Massachusetts’s healthcare cost growth benchmark development since 2013 and their efforts to partner with high-cost providers to lower costs. Since the first benchmark in 2013, the state’s cost trends have moderated, but he was clear that neither the benchmark or the Agency’s efforts alone moderated cost trends. In addition to research and reports, the Agency also convenes stakeholders to improve healthcare, partners with individuals, groups and organizations, and serves as a watchdog to assure market performance. Initiatives include one-time grants and assistance for small hospitals to improve care delivery and efficiency, oversees mergers and affiliations of hospitals and health systems, makes comprehensive annual policy recommendations to the legislature and Governor, and special projects such as reducing avoidable ER visits. The Agency is seen as an independent, non-political entity that prefers collaboration and assistance to lower costs, building trust.
The CT Health Policy Project and other panelists echoed the need to build trust in Connecticut’s health policymaking environment. Connecticut health costs are high but rising less quickly than other states. Strong evidence suggests that rising prices are the problem (up 18.5% in commercial coverage from 2013 to 2017) rather than utilization (down 1.1%). Drug costs are leading those price increases for Connecticut, even more than for the rest of the nation. Medicaid was highlighted as a particular success in lowering costs, highlighting the need to look beneath aggregate numbers. Medicaid’s PCMH Plus is a prime example of how applying a new initiative to lower costs to the wrong population can backfire and increase costs. Other speakers on the healthcare cost benchmarking panel included the CT Health Foundation, the CT Hospital Association, and the https://portal.ct.gov/OHSOffice of Health Strategy.