Floor remarks on Healthcare reform

IMG_2575Thank you Speaker DeLeo for your continued support and leadership in the healthcare arena. Because of your leadership, Massachusetts continues to lead the way in increasing access to care, improving quality, and increasing efficiencies in the delivery of services. Because of your leadership, these goals are shared by hospitals and the broader healthcare community.

I also want to thank the Majority Leader and the Gentlemen from Jamaica Plain for their commitment to healthcare, their expertise in this area, and their guidance in getting us here today under difficult circumstances.

For more than a decade, Massachusetts has been a leader in health care system transformation, as we have:-

  • Expanded insurance access by promoting shared responsibility among individuals, employers, and government
  • Adopted market-based insurance policies that promote balance between containing costs while maintaining value and comprehensive coverage,
  • Initiated system-wide reforms to promote integration in healthcare delivery and payment models to reduce fragmentation in health care by focusing on improvements in payment, delivery, insurance,
  • Expanded our data collection and analysis capabilities to promote transparency and support efforts to improve quality, patient safety and consumer education.
  • And invested in research and development to promote innovation in biotechnology, health information technology, and now digital health to bring forth new treatments and therapies that are curing sickness and improving lives.

Shared Responsibility

Balance

Integration

Transparency

Innovation

This is how we in this chamber have approached health care in the past, and this is the approach we will take in the legislation before you now.

House Bill 4617, the Honorable Peter V. Kocot Act to enhance access to high quality, affordable and transparent healthcare in the Commonwealth, is named after our colleague and a gentleman I had the honor of serving under as Vice-Chair of the Joint Committee on Health Care Finance. When he passed in February of this year, we made a commitment to follow the detailed outline he left us, and craft a bill that reinforced the principles he espoused, provides increased access to care for the residents of this commonwealth, improves the quality of their, and addresses the costs.

I am proud to stand here today and say that we have lived up to that promise.

The legislation we are considering today has been carefully crafted to consider the variety of stakeholders who have shared their priorities with the legislature. And I want to thank the many members who have weighed in and contributed to the development of this bill. It is crafted from dozens of bills filed by you and ultimately shaped around improving the experience for patients.

This bill takes significant steps at addressing some of the most pressing concerns in our health care system today – price variation, unnecessary cost growth, consumer engagement, and greater transparency. It harnesses technology and innovation to improve the delivery of care.

More specifically:

  • The bill includes policies that will help stabilize the finances of community hospitals and health centers to help these critical providers of care to transition to the new models of integrated, value-based care.
  • It contains new requirements for consumer engagement and greater transparency on health care costs and insurance plans designs. It will assist patients and employers in navigating their coverage options and shopping for care based on both quality and cost.
  • Under the legislation, consumers will also be protected from surprise bills, and notice provisions for out of network billing and facility fees will be strengthened.
    The transparency provisions also extend to the pharmaceutical industry, MassHealth, and pharmacy benefit managers.
  • The Act also advances innovation and harnesses technology by embracing telemedicine, reinforcing mobile integrated health, and expanding the mission of the Massachusetts e-Health Institute to accelerate the adoption of digital health.
  • We recapitalize the Prevention & Wellness Trust Fund and expand its reach by dedicating a percentage of the grants to support regional projects in communities that were not able to access funds under the first program.
  • It includes a number of provisions to expand access to healthcare providers and insures equitable access to healthcare resources.
  • And finally, the Act establishes some commissions and a task force to look at the financial stability of nursing homes, examine administrative costs in the healthcare system, and to look at existing special healthcare funds to evaluate them for effectiveness and efficiency.

I want to take a moment speak about some of the technological and innovative solutions offered in the bill – telemedicine, digital health, and data collection.

Telemedicine

Telemedicine is one of the fastest-growing care delivery services in health care today. It holds great promise to transform healthcare to be more accessible to patients where they are & when they need it. Our goal with the bill is to encourage the continued growth of telemedicine.

The language in this bill represents the nearly 4 years of discussions with the health care industry.

We wanted to clarify what we have in law to make sure that everyone is sticking to the same guardrails WITHOUT being too prescriptive, so the field can continue to innovate. We also wanted to make sure that patients are protected and receive quality care.

The bill’s telemedicine mandate requires all public and private insurance, including MassHealth, to cover telemedicine health services when 2 conditions are met:

  1. the service is covered when provided through in-person consultation or delivery, and
  2. the services “may be appropriately provided” through telemedicine

The bill also includes proxy credentialing to remove barriers for off-site clinicians to engage in telemedicine in hospitals & clinics. Once a provider is credentialed at one hospital, they will not have to undergo lengthy credentialing processes at every hospital where they provide telemedicine services.

And one last key approach in this bill: we keep the focus on the patient and require the Board of Registration in Medicine to promulgate regulations on the practice standards telemedicine services, which shall cover, without limitation:

  1. prescribing medications
  2. services that are not appropriate to provide through telemedicine
  3. establishing a patient-provider relationship
  4. consumer protections
  5. ensuring that services comply with appropriate standards of care consistent with Medicare conditions of participation telemedicine standards

Digital health

Digital Health can help improve primary care, reduce spending, and increase the overall efficiency for health care providers.

Apps that can help connect first responders to hospitals, data management systems, and technology developed for a healthcare transportation platform are all examples of successful results of prioritizing digital health.

Massachusetts is a known leader in innovation of biotechnology and health care and it is important that we also make Massachusetts a hub for digital health.

This legislation seeks to strengthen our support for the growing Digital Health sector by expanding access to grants offered by the Massachusetts e-Health Institute and the Health Policy Commission.

The (HPC), established in 2012, is an independent state agency charged with monitoring health care spending growth in Massachusetts and providing data-driven policy recommendations regarding health care delivery and payment system reform.

The Massachusetts eHealth Institute at the Massachusetts Technology Collaborative, is the designated state agency for promoting Health IT innovation, technology and competitiveness to improve the safety, quality and efficiency of health care across the Commonwealth of Massachusetts.

Investing in Digital Health is good for our economy, our health care system, and the public health in the Commonwealth.

Data collection

Massachusetts has a very large and thriving health care system with a number of governmental agencies tasked with analyzing data and recommending changes. We are fortunate to have agencies such as the Center for Health Information and Analysis and the Health Policy Commission as effective and crucial participants in the health policymaking process. This bill will further utilize these existing agencies through data collection that will examine the resources to find the best solutions for challenges in health care. It will help us maximize the impact of our existing data collection and policy development resources.

And the Commonwealth will be given the authority to more closely regulate and collect data on urgent care centers, office-based surgical centers, pharmacy benefit managers, and the Board of Registration in Medicine. This presents the potential for many opportunities to address high health care spending and improve quality of care.

Conclusion

In closing, the reforms in this bill will help us deliver more sustainable methods of improving health care in Massachusetts. The Massachusetts approach to health reform is not about squeezing out efficiencies and cutting cost, rather it is transforming how we seek to pay for care to promote cost-effective, value driven services in a way that makes the healthcare system more accessible and effective for all of us.

We continue to be a leader in health care and public health areas and this bill will indeed move us further along towards increased accessibility, higher quality, and more affordable health care for all.

Thank you.