Saturday, March 06, 2010

May I have the envelope, please?

In a post below, I listed several of the questions posed by the MA Division of Health Care Finance & Policy in preparation for the first of annual public hearings concerning health care provider and insurer costs trends. There were also others posed by the Attorney General. The answers to these questions have now been submitted by various parties. The answers are publicly available. You can open the envelope and see them here.

I haven't had time to review all the submissions yet, but the point I made a couple of weeks ago about federal and state underpayment for Medicare and Medicaid services, and the resulting impact this has on commercial insurance rates, is well documented in several of these filings. If I have a chance in the next few days, I'll pull out pertinent excerpts on this and other topics so you don't have to dig through dozens of pages.

5 comments:

Anonymous said...

Oh, but digging through dozens of pages is so much fun when you're retired..... (:
Especially when I actually took this seriously.

nonlocal

Anonymous said...

After a preliminary review of your and MGH's responses, I have to say I like yours better. (I am allowed to say what I want since I live nowhere near Boston.) First, you write better; second; I don't think it was my imagination that MGH struck a defensive tone. I recommend readers less OCD than I at least read the responses to question 14.
I have two questions:

1. I would like to review the responses from a "safety net hospital". Which of the responders would be considered such in Boston; I don't know them?

2. Can anyone explain to me why private insurers agree to pick up the slack for underpayment by government payors? I just don't get this - it's like a car dealer agreeing to sell you a car for less to allow you enough money to pay your taxes, or something. In short, it appears to be an unprofitable business attitude. Is there some law about this or something? What am I missing?

I'll keep reading, more later....

nonlocal

Paul Levy said...

1. Boston Medical Center, Cambridge Health Alliance, and Bay State Medical Center.

2. I don't know the answer, but it has always been an expectation in MA.

Anonymous said...

Anonymous, cost-shifting from public to private payers isn't just a Massachusetts phenomenon--it happens in every state in the country. Public sector will generally argue that it is paying adequately assuming reasonable costs; private payers and providers will argue that public payers are under-paying. Probably some merit to both arguments. Nancy

Anonymous said...

Yes, but how do the providers get the private insurers to pay at 132% of par (as MGH asserts) to compensate for underpayment by the government? I seem to remember Charlie Baker saying on his blog (while he was still running the insurance co.) that private payors rates started from Medicare and went up. Why? I sure wouldn't do that if I were a business providing a service. Some salient fact is missing here. (ps I want to know because it is probably driving my premiums up!)

nonlocal