White Coat Notes

Insurers warned on costs by state

Excerpts from the Globe’s health care blog.

Leaders of the Group Insurance Commission, which administers health benefits for the families of state employees and retirees, have drawn a line in the sand.

Insurers who want to offer plans starting in April to the nearly 400,000 people the commission serves must agree to lower costs of coverage — and save the state money — in the last years of a five-year contract.

“I do not mean increases that are lower than they might otherwise have been,” said Dolores Mitchell, executive director, speaking at the annual conference of the Massachusetts Association of Health Plans. “ ‘It could have been worse,’ is not what we have in mind. I mean lower total dollars spent.”


Mitchell said that when Governor Michael Dukakis hired her to lead the commission 25 years ago, he asked her to control “the cost monster.”

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The commission has “tried everything,” including limiting which doctors and hospitals enrollees can visit, conducting physician performance evaluations, and introducing programs for managing chronic diseases.

“But,” she said, “I do not feel at this moment in time that I have yet gotten my arms around the cost monster.”

The state’s new health cost control bill, the election results, and the preservation of the federal Affordable Care Act serve as leverage for bold action, she said.

Mitchell said she knows that some have said the commission is asking for too much in too little time.


“It is indeed possible that some of those naysayers are here today in this room,” she said, to a room packed with health plan executives, their staff members, and policy analysts. “You don’t need to identify yourselves. I already know who you are. We say, in response, ‘We have waited long enough.’ Twenty-five years to get serious about a problem that we’ve known about for 25 years, it seems to me, is more than enough time.”

Foundation president to be Blue Cross officer

Sarah Iselin will leave her post as president of the Blue Cross Blue Shield of Massachusetts Foundation this month to become chief strategy officer for the ­nonprofit’s namesake insurer. She has led the ­foundation since 2009.

Iselin previously was commissioner of the state Division of Health Care Finance and Policy, where she played a major role in implementing the 2006 health care law, which expanded health insurance coverage in Massachusetts.

Before that, she had developed safety and quality programs for Blue Cross Blue Shield of Massachusetts, the largest insurer in the state, and worked at the foundation on the group’s Roadmap to Coverage initiative, which included a public debate and series of reports that laid the groundwork for passage of the 2006 law.

The foundation is a private nonprofit established in 2001 with a $55 million endowment from the insurer.

Chelsea Conaboy
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