Our Healthcare “Wish List” for the New Administration

| Posted On Dec 19, 2014 | By:

As Charlie Baker takes over as Governor on January 8th, there are a myriad of issues the new administration will be tackling, many of them related to healthcare. Atrius Health has assembled our own top 10 healthcare “wish list” for the administration to consider.

  1. Increase Medicaid funding for all providers, including home health (who have not seen rate increases in nearly seven years), primary care providers and behavioral health providers, who are working hard to care for some of the state’s most vulnerable populations in the state.
  2. Update the DPH clinic license regulations For example, the requirements for Behavioral Health are extremely burdensome and do not lead to improved quality, the medical records section assume a paper record.
  3. Assess the Determination of Need process – e.g. MRI is still defined as a “new technology”; if no longer a “new technology” then groups could have MRIs  which would increase competition and decrease cost, especially in light of pricing transparency without having to go through the regulatory approval.
  4. Continue to work on enhancements to the state’s Prescription Monitoring Program – including improvements of registration/access; ease of use; changes to current requirements relative to delegates and promote interfacing directly with provider’s existing electronic health records (EHR’s) wherever possible.
  5. Provide enhanced funding to the DPH in support of the Health Planning Council and its important work to generate a state Health Plan. While the work of the Council has been impressive and has led to the development of a comprehensive analysis of the behavioral health landscape, limited resources have hampered the ability to develop a similar analysis of other important health care topics/resources.
  6. Incentivize more providers to utilize the Massachusetts Health Information Highway (MassHIWay) to facilitate more care coordination and eliminate duplication of unnecessary tests/procedures. Using the model of the federal “Meaningful Use” initiative, consideration should be made to provide financial incentives to support use of the MassHIWay, but in subsequent years penalize those who have not yet connected.
  7. Support cost transparency – While we support cost transparency, we believe this should be a payer responsibility and do not believe that this alone will solve the issue of rising healthcare costs in the state. Currently cost information is published annually by the Center for Health Information and Analysis and the Health Policy Commission, however the existence of this information alone has not measurably changed patient behaviors. Additional education of consumers to evaluate value is an important (and still missing) component in solving the complex issue of the rising costs of health care.
  8. Support the creation of more primary care resources including incentive programs such as loan forgiveness for physicians who complete a primary care residency and practice in the state for several years, encouraging UMass Medical School to more aggressively promote primary care training programs for residents, and supporting changes to state law allowing licensees to practice at the top of their license.
  9. Promote the advancement of alternative provider payments such as global payment that incents coordination of care, evidence-based care, preventive health, high risk patient management, and population management.
  10. Improve Behavioral Health care by facilitating increased payment to behavioral health clinicians, eliminate behavioral health “carve outs” and barriers to care such as prohibitions by some health plans on paying for appointments for counseling and medication management that occur on the same day, and supporting efforts to integrate behavioral health into primary care such as current efforts underway by the Health Policy Commission on certification standards for Patient Centered Medical Homes (PCMHs).

These are but a few of the items we hope the Baker administration will consider and we look forward to working with the new leadership in the Governor’s office as well as legislators and state policymakers in the coming year.

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  1. Very thoughtful breakdown on realistic (and much-needed) ways to improve healthcare as an industry from the ground up. Thanks for sharing.

    Comment by Brian on December 19, 2014 at 11:02 am

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