The debate centered around a possible ballot initiative that would cap insurers from reimbursing providers greater than 20 percent of the average cost for a service, and would require them to pay no less than 10 percent below the average price to a provider.
The ballot measure has largely been seen as a scare tactic designed to spur healthcare officials into reformative action. As the ballot deadline creeps closer, however, industry experts are determined to find an alternative.
Below are four thoughts hospital industry leaders shared during the hearing.
1. Norwood (Mass.) Hospital President Kim Basset said the highest-priced hospitals are routinely reimbursed two-and-a-half to three times higher than hospitals with the lowest prices for the same services. “Immediate action is needed,” Ms. Basset said. “If certain hospitals are allowed to be paid more than others, they will continue to use these proceeds to create an unfair market advantage against community hospitals.”
2. Marna Borgstrom, CEO of Yale New Haven (Conn.) Health System and CEO of Yale-New Haven Hospital, said hospitals in her system — Yale-New Haven, Bridgeport (Conn.) Hospital and Greenwich (Conn.) Hospital — serve mostly Medicare and Medicaid patients, with only one-third of patients covered by private insurance, according to Hartford Courant. “We have no negotiating abilities” with government payers, Ms. Borgstrom said.
3. Tim Genz, executive vice president of Massachusetts Hospital Association in Burlington, advocated for increased price transparency to urge consumers to use lower-priced providers.
4. In reference to the proposed ballot question, Steve Walsh, executive director of the Massachusetts Council of Community Hospitals, said, “[We used] a blunt instrument to start a conversation that needs to be started, but… this is the right church, wrong pew.”
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