To sustain the landmark Massachusetts health insurance initiative, the state must find ways to control the climbing costs of health care, policymakers said at a May 14 forum on the first year of health care reform.
Senate President Therese Murray (D-Plymouth) said the state could save hundreds of millions of dollars by adopting several proposals being developed in the Senate. Perhaps the most controversial is to mandate that doctors and hospitals switch to electronic medical records within five years. She said this and other investments in technology would save money by “cutting through the mountain of bureaucratic paperwork and improving worker productivity.”
But she declined to provide details of the proposal or how it would be funded. A pilot effort to implement electronic records in three communities is underway with a $50 million grant from Blue Cross and Blue Shield of Massachusetts. Some estimate the cost of a statewide effort at $500 million. Some specialists suggest that electronic medical records alone will not save much money, but have the potential to change medical practice over time.
In the proposed Senate budget, unveiled during the week of May 14, Murray said the Ways and Means Committee will include financial incentives to encourage medical students to choose primary care, funds for management of chronic diseases, and money for preventive care, all of which, she said, could help reduce health care spending.
“If we do not constrain health care costs, the system we worked so hard to create and implement will collapse,” Murray said at the forum at the Kennedy Library sponsored by the Blue Cross Blue Shield of Massachusetts Foundation, the Massachusetts Health Policy Forum, and the Massachusetts Medicaid Policy Institute.
The insurance initiative, designed to ensure most Massachusetts residents have coverage, is expected to cost nearly $1.7 billion this year. The federal government, which is providing the bulk of funding, has said it will not provide significant increases in future years.
The health reform law established a Cost and Quality Council that has begun to look for savings. Dr. JudyAnn Bigby, secretary of health and human services, who chairs the council, said it would consider ways to reduce use of high-cost medical procedures that don’t deliver clear benefits. “More is not better” in many cases, she said. In addition, she said, the state should work to reduce costly health problems like obesity.
Leslie Kirwan, state secretary of administration and finance, said the state is also working to “improve the efficiency of MassHealth,” the state Medicaid program that is being used to cover a portion of the uninsured.
Despite Murray’s estimate, it’s unclear how much any of these measures would save.
“The evidence is that they work but can take a long time,” said Stuart Altman, a professor of health policy at Brandeis University, who helped moderate the forum. Speaking in an interview after the forum, he said, “In the short term, the questions we need to answer are: Do we need all the care we’re getting? Are we paying the right amount to the right people?”
Alice Dembner ([email protected]) is a staff writer at The Boston Globe, where this story originally appeared on May 15. Reprinted with permission.