Is the New System of Health Insurance in Massachusetts Saving Money?

AGO SealOn June 22nd, 2012 the Massachusetts Attorney General Office (AGO -Martha Coakley) published their report called Examination of Health Care Cost Trends and Cost Drivers -Report for Annual Public Hearing”.  This report was an examination of health care cost trends and cost drivers in the Massachusetts health care market. In 2008, the Massachusetts Legislature passed “An Act to Promote Cost Containment,Transparency and Efficiency in the Delivery of Quality Health Care”, which authorized the Attorney General to review and analyze the reasons why health care costs continue to increase faster than general inflation.

Even though Massachusetts has expanded coverage to 98% of its population through the shared responsibility of individuals and employers…

In the 2010 Report, they examined whether the existing health care market changes in Massachusetts has successfully contained health care costs, and “found the answer to be an unequivocal ―No!”

The market players – whether insurers, providers, or the businesses and consumers who pay for health insurance – had not effectively controlled costs, in part, because the prices negotiated between insurers and providers were not designed to encourage or reward provider efficiency. The resulting market dysfunction has threatened the viability of efficient providers, who have lost ground on payment rates while also losing patient volume to higher priced competitors.

It is essential that businesses and consumers be engaged in efforts to promote a value-based health care market. Providers cannot coordinate care without the alignment of varying interests of consumers, purchasing employers, and health insurers. We should not expect to fix the system by shifting the risk and responsibility for efficient care management from health insurers to providers through Accountable Care Organizations (―ACOs‖).

the AGO stated “A shift of payment methodology by itself is not the panacea to controlling costs. Moreover, the information we reviewed shows that the shift to global payments without other fundamental changes may not only fail to control cost, but may exacerbate market dysfunction and market inequities by establishing widely different per member per month rates based on historic pricing disparities.”

Ouch! Guess what?  There is a successful system out there to be built.  It involves putting proactive integrative & holistic modalities at the FOREFRONT of care.  There are many studies that have been done on the clinical success and cost effectiveness of these forms of natural medicine.  We are creating a huge shift in the way medicine is practiced, please become a FREE member of the association and show your support of this kind of new paradigm of healthcare!