Each Patient Counts: Massachusetts Medical Society Weblog

The Massachusetts Medical Society Blog Has Moved!

Effective October 15, 2009, the Massachusetts Medical Society blog moved to

http://blog.massmed.org

Please visit us at our new site for continuing updates, and subscribe to our feed there.

(All posts on this site have been exported to the new site.)

At the State House, MMS Leaders Urge Caution and Pilot Projects for Payment Reform

Massachusetts Medical Society physicians joined several health care providers Thursday in urging the State Legislature to move carefully in adopting a new payment model for physicians and hospitals.

MMS President Mario Motta, MD, said, “If we move too quickly and rattle the tree too abruptly, you’re going to have physicians fall out of their practice like leaves on a tree.” His comments came during a three-hour hearing held in a packed committee room in the basement of the State House.

Motta said that while some physicians work under a global payment system, it’s never been tried before on a system-wide basis. “There are many unknowns and unpredictable effects that could happen,” he said. “For that reason, we are strong advocates for establishing pilot projects for these innovations.”

But, Motta noted, “Coordinated care is better than fragmented care. We want to support innovations that move us in that direction. It’s better for the patient, and it’s better for our health care system.”

MMS President-Elect Alice Coombs, MD, was a member of the commission that studied alternative payment models in the state. She said, “A new payment model is worth looking into if, and only if, there is adequate time, support and preparation for physicians making this enormous transformation.”

Coombs told the committee about the concwerns she’s heard from physicians statewide about global payments. “Most of all, physicians have been saying, We’ve tried this before. It was called capitation, and it didn’t work.”

She said physicians ask how they will be protected against undue financial risk, whether physicians will get adequate resources to provide the right care, and whether patients will trust a global payment system. She said the Legislature must address these and other issues before implementing a new payment model.

Coombs also added an “urgent plea” for naming practicing physicians to any oversight authority for payment reform. “One thing we learned at the commission,” she said, “is that the voice of the practicing physician is absolutely essential to developing a system that will work.”

Most other health care providers testifying also urged a careful, deliberate implementation, including representatives of family physicians, Cambridge Health Alliance, and the Massachusetts Hospital Association.

Others disagreed. The outgoing secretary of Administration and Finance for the state, Leslie Kirwan, said, “Standing still or inching forward is in fact falling back.” Marylou Buyse, MD, president of the Massachusetts Association of Health Plans, said, “We don’t have the luxury of five years.”

Dolores Mitchell, executive director of the state agency that purchases insurance for state employees, said payment reform “may be our last best hope” for controlling health care costs.

Watch Dr. Motta's testimony (Length: 7:56)

Watch Dr. Coombs' testimony (Length: 6:40)

Additional Resources

• MMS News Release: MMS Physicians Testify on Payment Reform
• Text of Dr. Motta's remarks
• Text of Dr. Coombs' remarks

AMA Comments on 3 Issues In Senate Finance Legislation

The American Medical Association today released three brief position papers on three issues in the Senate Finance Committee health reform legislation, which the committee will likely vote on this coming Friday.

• Independent Medicare Commission
• Repealing Medicare's Sustainable Growth Rate (SGR) payment mechanism
• Resource Use Outliers

These documents are in PDF format, available on the AMA's Health System Reform website.

The MMS health care reform website is available here.

Payment Reform Hearing Set for Thursday; MMS to Testify

The state legislature's Joint Committee on Health Care Financing meets Thursday afternoon to hear general testimony about the payment reform commission's recommendations on global payments. The MMS will testify, along with many other specialty societies, hospital leaders and other health care stakeholders.

There has been no legislation filed yet, so there are no specific proposals for implementing the commission's recommendation. It's expected that each speaker will provide general thoughts about global payments. Undoubtedly, some will offer specific ideas for the legislation

We'll report on the hearing here tomorrow, and post our testimony to the MMS website.

Last Sunday's Boston Globe previewed the hearing with a front page story by Liz Kowalczyk. It outlined about the recommendations concerns from hospital and physicians leaders, including MMS President Mario Motta, MD. 

“It can’t be forced on everyone,’’ said Dr. Mario Motta, a cardiologist in Salem and president of the Massachusetts Medical Society, a lobbying organization for the state’s physicians. “You’ll force [doctors] out of business.’’

“This plan will never happen for everyone in five years; that’s an unrealistic dream,’’ he added.

For background information on the commission and its work, visit the payment reform section of the MMS website at www.massmed.org/paymentreform.

MMS Flu Advisory: Mass. Announces First Autumn Death from H1N1

The victim was a 55-year-old woman from Middlesex County with "multiple underlying health conditions."

Department of Public Health Commissioner John Auerbach's statement said, in part, “While most cases of H1N1 in Massachusetts and across the nation have been relatively mild, this news demonstrates once again how serious flu can be.”

Read the complete DPH announcement.

Follow the MMS Twitter feed.

Senate Committee to Vote on Health Bill Next Week

Just after 2:00 this morning, the Senate Finance Committee completed its grueling review of nearly 600 amendments to its health reform legislation. Its leaders hope to vote on the complete bill next week. The committee plans to vote on the full bill during the week of Oct. 12.

During its deliberations this week, the committee rejected two separate proposals to include a public health plan option. It also exempted 2 million more people from the individual mandate based on economic hardship, and reduced penalties for failing to comply with the mandate.

Thanks to the work of Sen. John Kerry and his staff, the committee also favorably modified a proposal that would have penalized patients and physicians in high-cost Medicare states like Massachusetts.

Read more about the committee’s deliberations.

MMS website: Health care reform updates and other resources