Atrius Health Submits Pre-Filed Testimony to the Health Policy Commission

Government & Policy Cost of Care

| Posted On Sep 21, 2015 | By: Atrius Health

Atrius Health recently submitted pre-filed testimony to the Health Policy Commission (HPC) in advance of the Annual Health Care Cost Trends hearings that will take place October 5-6, 2015 at Suffolk University Law School.

Atrius Health was among approximately 70 health care provider organizations and payers statewide asked to submit pre-filed testimony on a variety of topics including alternative payment methodologies, steps taken to ensure the state met the benchmark in 2014, price transparency, barriers and provider price variation.

The HPC also asked organizations to describe systematic or policy changes that have encouraged them to operate more efficiently without reducing quality.  In its written testimony, Atrius Health noted the following recommendations to the HPC and other state policymakers:

• Current state law limits the ability of behavioral health clinicians to share information and this poses a significant barrier to provision of coordinated, cost-effective care. Payer prohibitions on billing for both medication appointments and counseling and/or shared medical appointments on the same day also reduce efficiency in the delivery of care for providers and patients.  This restriction imposes a significant inconvenience to patients who must make two separate appointments, results in less care than needed at times and does not have a clinical foundation.

• We support review and revision of open access laws regarding behavioral health, OB/GYN, and emergency department services. We understand that these laws were intended to support patient choice and ensure patients can access certain services, but their breadth limits the ability of primary care providers to effectively coordinate care and discourages alternative payment arrangements where providers assume risk for payment for the full range of health care services.

• The administration, legislators and the HPC should help foster reforms on both the state and federal level that leads to reimbursement for innovative technologies such as telemedicine that can drive down total medical expense (TME). Expanding such reimbursement would encourage more efficient operations by allowing patients to be cared for in the home when transportation, mobility issues or other factors might limit a patient’s ability to come for an office visit.

• The state should enforce the requirement in Chapter 224 that the health plans attribute PPO patients to PCPs (or physician groups) and share the claims data with that PCP. This would enable the same kind of risk assessment that we do on our HMO patients so that we can proactively provide services to keep patients out of the hospital. This should include behavioral health data so that we can similarly assess risk for these patients.

• The state should require hospitals to provide interoperability that would allow community providers to view the medical records of their own patients.

• We support efforts that would require hospitals/skilled nursing facilities to consult with the patient’s primary care provider for the preferred referral to home health agencies.

• We urge the HPC to work with other state policymakers and stakeholders to develop a requirement that hospitals notify the patient’s primary care provider upon a patient’s admission to a hospital. There is considerable variation among hospitals in providing this information, which results in poor coordination of care – and thus increased risk and reduced quality of care – both during the hospital stay and upon discharge.

• Price transparency has been difficult for payers and providers. A different approach to consider would be to have the state develop a real-time, online self-service program for consumers that would allow them to access this information in one place.

All pre-filed testimony including the full text of Atrius Health’s testimony will be posted here.

The annual hearings, required under Chapter 224 will include experts as well as witnesses who will be testifying during the hearings on drivers of health care costs.  Steven Strongwater, MD, President and Chief Executive Officer, will be one of 30 individuals called upon to testify in person during the two-day Cost Trends hearings.  Dr. Strongwater will testify on October 6^th as an expert witness on a panel “Meeting the Benchmark in 2015 and Beyond.”  The pre-filed and live testimony will be the basis of the HPC’s Annual Cost Trends Report that will be filed at the end of the year.