Massachusetts Attorney General Martha Coakley released a detailed report—the third in a series dating back to 2010—that examines the recent health care trends and developments in the consumer, health plan and provider sectors. The report also provides recommended actions for government agencies created to monitor trends in health care spending, specifically the new Health Policy Commission (HPC), the Center for Health Information and Analysis (CHIA) and the Division of Insurance.
The Attorney General’s report notes that purchasers are moving out of HMO products and into tiered and limited network products, PPO products and high-deductible products. The report also notes that health plan payments continue to vary significantly and that growth in prices, not utilization, is the primary driver of increased costs.
While the report notes some positive trends in controlling health care costs, significant disparities in total medical expenses persist among and within regions in Massachusetts, and that such disparities are not explained by differences in underlying health status. The report also finds that providers are taking on increased performance risk under extremely complex payor contracts.
The Attorney General’s report concludes with recommendations for government agencies as each continues to reconcile the data gathered and trends in the marketplace. Specifically, the report places the burden on the HPC and CHIA to collect detailed information about the operations and finances of providers and the management of care delivery by providers. The Attorney General encourages increased transparency in cost drivers by recommending that CHIA allow consumers, health plans and providers to have access to de-identified health insurance claims data and the total medical expenses attributable to public and private payers.
With the release of the Attorney General’s report and recent action by the Massachusetts legislature and governor to pass legislation aimed at bending the health care cost curve, it is clear that Massachusetts will continue to keep a watchful eye on all participants in the health care system. For more information on the Attorney General’s report, please contact your regular McDermott Will & Emery lawyer or an author.
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