MMS Vice President Named to State Payment Reform Commission

Governor Patrick has named MMS Vice President Alice T. Coombs, MD, (right) to the new Payment Reform Advisory Commission. Dr. Coombs is a critical care specialist at South Shore Hospital and an anesthesiologist with South Shore Anesthesia Associates.

The commission was a creation of the massive health care bill that passed the state legislature during the last session. It is charged with evaluating the health care payment system and recommending reforms that will provide incentives for cost-effective and patient-centered care.

According to Governor Patrick's news release, "The group will evaluate innovative methods for health care payment, including medical homes, global budgeting, and capitation rates."

Dr. Coombs said, “I am honored to have been chosen as a member of the Commission and represent physicians in this critical effort.

"Payment reform is an essential part of health care reform. Such reform will address the existing disparities between quality and volume-driven payment structures, a situation that has aggravated our ability to deliver all-important primary care. It will also help to address health care needs for all residents, particularly the under-served, especially as we confront increasingly tight budgets and a weak economy.”

The commission is co-chaired by Leslie Kirwan, Secretary of Administration and Finance, and Sarah Iselin, Commissioner of the Division of Health Care Finance and Policy. Other members include:

• Dolores Mitchell, executive director of the Group Insurance Commission
• Sen. Richard Moore, Senate chair of the Health Care Financing Committee
• Andrew Dreyfus, executive vice president of health care services for Blue Cross Blue Shield of Massachusetts
• Deborah Enos is president and chief executive officer of Neighborhood Health Plan
• Nancy Kane, DBA, professor of management and the associate dean for educational programs at the Harvard School of Public Health
• Lynn Nicholas, FACHE, president and CEO of the Massachusetts Hospital Association
• Christie Hager, chief health counsel to the House Speaker

Comments

[Bruce L. Bender MD, MS, FACPE]

How on earth can this group of people be expected to come up with meaningful payment reform, except for Sen. Moore and Ms. Hager? Where are the citizens and business people? The system needs to control cost and increase access. This group will not do that.

Our current system has twice the administrative costs of Canada. If we reduced those costs to Canadian levels the state would save at least 9 Billion dollars a year. The way to do that is to abandon the incredibly complex and wasteful system we have now and embrace a single payer system with cost controls. We need global budgeting. We need certification of need. Alternatively, we could eliminate insurance and subsidization and see how much people are willing to pay for health care. We need total health care cost in MA to decrease as a percentage of GDP until it is not more than 12% of GDP.

This state had 338 specialists and 20 generalists per 100,000 population several years ago. The rest of the US had 220 specialists and 31 generalists. The rest of the world has far fewer doctors overall with more generalists and many, many fewer specialists, which is what works. When is the MMS going to work to align training programs and positions available with population need, not reimbursement opportunities?