Health Care

Mixed Reaction To Patrick's Health Care Reform Bill

By Sarah Birnbaum   |   Friday, February 18, 2011
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Feb. 18, 2011

BOSTON — Massachusetts Governor Deval Patrick is filing a bill Thursday that aims to reduce health care spending by changing the way doctors and hospitals get paid.  Most insurers and health care providers reacting to the bill are positive, but cautious.  
Patrick's bill would move the state toward a so-called “global payment” system, where doctors and hospitals receive a lump sum per patient, plus bonuses for keeping the patient healthy, instead of getting paid for every office visit, test and procedure.  The governor says the change will save money, because there won’t be a financial incentive for doctors to order unnecessary and costly tests.

 Blue Cross and Blue Shield, the state’s largest health insurer, is already paying some doctors this way.  And Blue Cross CEO Andrew Dreyfus says the system is working.
“Quality is going up, costs are coming down, and I think as those experiences are understood, people are actually going to see – this is a better system,” Dreyfus said.
Dr. Alice Coombs is president of the Massachusetts Medical Society.  She says one in five Bay State doctors are already in a global payment system, but she says many other doctors are worried they won’t be able to afford new electronic health records which would be required under the new system.
“They want to know what do I need in order to do this? They need the bells and whistles, the infrastructure, if you will, the electronic medical records and those things… it takes capital to get there," Coombs said.

Health care providers and insurers say the way forward will be complicated. Earlier this week, the state’s largest union representing healthcare workers recommended that changes to the payment system should be made gradually.

Health care advocacy groups, however, have urged lawmakers to act quickly, saying the recession has led to a jump in the number of people struggling to pay health care premiums.

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What Does the MGH U.S. News Ranking Mean?

By Jordan Weinstein   |   Tuesday, July 17, 2012
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July 17, 2012

wgbh news image
The Yawkey Pavilion at Mass. General Hospital. (Courtesy MGH)

BOSTON — If you work in the medical field and especially a hospital, there was probably quite a buzz at work on July 17. That's because the annual Best Hospitals ranking was released by the U.S. News and World Report. Massachusetts General Hospital ranked first and Brigham and Women's ninth. MGH president Dr. Peter Slavin called the ranking a "tribute to the more than 23,000" staff at the hospital. 
But how much should we pay attention to these rankings? Do they even matter? To gain insight and perspective, I talked with Dr. Harlan Krumholz, professor at Yale School of Medicine. He said that despite the popularity of these lists, there is currently no good place to get reliable information on hospitals: All ratings seem to have their bias and are not completely based on hard outcomes data. However, Medicare is working on a possible solution.

House Votes to Override Governor on Three Key Issues

By Sarah Birnbaum & Cristina Quinn   |   Wednesday, July 11, 2012
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July 12, 2012
BOSTON — Massachusetts House lawmakers have pushed back against Gov. Deval Patrick on welfare restrictions, mental health and immigration checks.
EBT and the RMV
When he signed the budget on July 8, the governor rejected a measure that would have banned the use of EBT swipe cards at jewelry stores and nail salons, saying he wasn't going to make vulnerable people beg for their benefits. He also rejected a provision that would require the Registry of Motor Vehicles to ask for proof of legal residency. He said state agencies should not enforce federal immigration law.
But on July 11, House lawmakers voted overwhelmingly to keep the original proposals alive. Rep. Carl Sciortino (D-Medford) opposed the governor’s changes but he said he was doing so with a heavy heart.
“This is a difficult debate and a difficult decision and I hope as a body we can get back to the debate about how we take care of the working families that are struggling against the Commonwealth rather than penalizing families who are seeking our assistance,” he said.

> > LISTEN: Emily Rooney discusses the EBT issue on Boston Public Radio
Taunton State Hospital
Lawmakers also voted unanimously to override a line-item veto that would have eliminated the 45 inpatient mental health beds at Taunton State Hospital, making Worcester the nearest location for inpatient treatment.
Rep. Patricia Haddad (D-Somerset) encouraged fellow lawmakers to show empathy: “If your loved one had a heart condition, and you were told that the only place they could go was Worcester, how would you feel? Would you willingly accept that as an answer? Well, I’m asking you if that’s fair to people with mental illness in their families — and I think you’re all going to answer 'no.'"
Rep. Sarah Peake (D-Provincetown) added that her constituents already faced enough of a transportation challenge as is. "Taunton is already quite the drive and quite the trip to make, and as we know, and as we’re treating people with their mental health issues, their support system is critically important,” she said.
After the vote, Karen Coughlin, a longtime nurse at Taunton State, said she was thrilled. "Success all around is the way we look at it," she said. "We would have liked to avoid this — would we have liked to have more than 45 beds? Absolutely. But you know what, we will take this as a victory."
The issues now move on to the Senate for further action — and ultimately back to Patrick for his final review.

About the Authors
Sarah Birnbaum
Sarah Birnbaum is WGBH News' State House reporter. Send her a news tip.
Jordan Weinstein Jordan Weinstein
Jordan Weinstein is a news anchor for NPR's All Things Considered on WGBH, 89.7 FM in Boston.


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