Boston – The Senate and House on Thursday reached consensus on comprehensive legislation that will usher in the next phase of health care reform in Massachusetts with a package of new initiatives aimed at bringing down escalating health care costs and creating greater access to primary care.
“This legislation presents an impressive set of reforms intended to ignite the process of driving down costs,” stated State Senator Benjamin B. Downing (D – Pittsfield). “By promoting transparent systems of quality improvement and cost containment, expanding roles for nurses and setting new standards for pharmaceutical marketing practices, this measure is designed to eliminate inefficiencies in the health care system.”
The legislation promotes the modernization of the health care system to reduce waste and improve quality care, establishing the Commonwealth as a national leader in the statewide adoption of electronic medical records and uniform billing, which together could save hundreds of millions of dollars.
“This legislation is crucial for the future vitality of our health care system and our economy,” said Senate President Therese Murray (D-Plymouth). “It establishes bold reforms in the structure and operation of our health care industry that will bring down costs, improve access to primary care and establish transparency measures for providers and insurers alike. This is an exclamation point on the end of a very productive legislative session, and I couldn’t be happier with the hard work and collaboration that went into this legislation. I look forward to the Governor signing it as soon as possible.”
The compromise legislation authorizes the Division of Health Care Finance and Policy and the Attorney General to hold an annual public hearing with health care providers and health care insurers to investigate and report on health care cost drivers and make cost-reduction recommendations. It also creates a Special Commission on Health Payment Reform to investigate restructuring the current payment system to provide incentives for efficient and effective care. The 15-member commission will make its recommendations no later than April 1, 2009.
The legislation requires the Department of Public Health to set a new “marketing code of conduct” that all pharmaceutical and medical device companies must adopt and comply with, as enforced by the state. The standard will include all the restrictions and guidelines in the most recent versions of industry-adopted ethics codes. The compromise language also requires all pharmaceutical and medical device companies to disclose the value, nature, purpose and recipient of any fee, payment, subsidy or other economic benefit with a value over $50 that goes to any health care professional in the Commonwealth.
Other provisions of the bill include:
- Strengthening the Determination of Need (DON) process for outpatient capital projects and ambulatory surgery centers to help maintain standards of quality and ensure the efficient and equitable deployment of health care resources across the Commonwealth;
- Authorizing MassHealth to establish a “Medical Home” demonstration program to promote coordinated, comprehensive patient care and strengthen the role of primary care providers;
- Creating a new loan forgiveness program for doctors and nurses who commit to practicing certain specialties in medically underserved areas, administered by the Health Care Workforce Center;
- Expanding enrollment at UMass Medical School for students committed to primary care specialties;
- Creating an enhanced “learning contract” for UMass Medical students who commit to working four years in primary care in Massachusetts, providing a greater tuition incentive for those who participate, but also including a tougher penalty for students who don’t complete their commitment;
- Required reporting of “serious reportable events”, adverse drug events and hospital-acquired infections; and
- Requiring physician competency in health information technology for board registration by the year 2015.
The legislation’s requirement for the statewide adoption of electronic medical records also sets a goal of 2015 for implementation and dedicates $25 million for the financing and deployment of the system, which will be overseen by the new Massachusetts e-Health Institute. After 2015, the use of an interoperable health record system would be required for hospital licensure.
The legislation sets a goal of 2012 for statewide adoption of Computerized Physician Order Entry systems (CPOE). After this date, the use of CPOE systems would be required for hospital licensure. Additionally, the legislation’s standard for uniform billing among health care providers and insurance companies will simplify the current billing structure to reduce administrative costs and errors.
The bill now goes to the Governor for his signature.