Massachusetts is considered a national leader for expanding health insurance coverage to nearly all of its residents. But can it be a leader in changing the way health care is delivered so that it costs less and is better for patients?
During a week of big questions, this may be one of the biggest. Governor Charlie Baker and health care leaders from Boston and beyond will tackle it Wednesday at Massachusetts General Hospital during an all-day symposium that is part of HUBweek, the art, science and technology festival sponsored by Mass. General, The Boston Globe, Harvard University, and MIT.
“Massachusetts was a leader in insurance reform,” said Dr. Timothy G. Ferris, senior vice president of population health management at Partners HealthCare, Mass. General’s parent company, and an organizer of the forum. “But the end goal is to get more efficient, better care to the population, and ultimately better health. The question of the symposium is: Is this playing out in Massachusetts?”
The discussion comes as hospitals and insurers are under growing pressure to control the costs of medical care while also improving the quality. In Massachusetts, the state has set a benchmark to hold the annual increase in health care spending at or below 3.6 percent; last year, spending climbed 4.8 percent, due largely to higher costs of Medicaid, the government program that insures low-income residents.
Massachusetts is home to some of the nation’s best hospitals, but also has among the highest health care costs in the country. To control costs and improve care, many health care organizations are employing new strategies, such as using care managers to coordinate the treatment of patients with chronic disease, or using fitness trackers to monitor how much patients exercise.
Ferris said health care providers have a lot of room for improvement. Patients want to e-mail their doctors, schedule appointments online, and find information on the costs of medical services, he said — all things that seem simple, but are not yet commonplace in the industry.
Kate Walsh, chief executive of Boston Medical Center, said the challenge before health care leaders is to bring costs down, but without slowing innovations in drugs, treatments, and medical devices that play a big role in the Greater Boston economy.
“If you think about it, in most industries when you apply technologies, cost comes down,” Walsh said. “It doesn’t seem to happen in health care, so what can we learn from other industries so we can manage costs?”
Walsh and three colleagues — Andrew Dreyfus, chief executive of Blue Cross Blue Shield of Massachusetts; Dr. Peter L. Slavin, president of Mass. General; and Daniel Tsai, assistant secretary of the state’s Medicaid program — will address this thorny question at the forum.
“Managing costs, that’s something I think we continue to work on,” Walsh said. “As an industry, everyone’s committed.”
The Wednesday forum will include discussions about preventive care, chronic care, and the idea of patients as consumers. Baker, the former chief executive of Harvard Pilgrim Health Care and state secretary of Health and Human Services under former governor William Weld, will be the keynote speaker.
Other HUBweek health care events will touch on Alzheimer’s, cancer, addiction, and precision medicine.
Dr. David Blumenthal, a former Partners executive who is now president of the Commonwealth Fund, a New York foundation that studies health care issues, said HUBweek is a good opportunity to reflect on the progress Massachusetts has made.
The state led the way in expanding insurance coverage years before the Affordable Care Act, and has since adopted new payment systems aimed at controlling costs while improving care faster than many other states. These newer payment models reward doctors based on the quality of care they provide, rather than reimbursing them for every service and procedure, as under the traditional fee-for-service payments.
But costs remain a challenge here, Blumenthal noted, due at least partly to big research and teaching hospitals such as those owned by Partners. Such hospitals have high costs to support their missions to train doctors and do medical research. They can also extract higher rates through their market power, the state Health Policy Commission and attorney general’s office has found.
The state “is obviously falling short of its [cost control] goals, and it’s going to be an example to the rest of the country how it reacts to that and brings those costs back down,” Blumenthal said. “Massachusetts starts from a high base. Its high base reflects a very expensive infrastructure and that’s something the state will have to deal with.”