BOSTON – House Speaker Robert A. DeLeo (D-Winthrop) announced the creation of an advisory group to study managed care organizations (MCOs), which have been suffering significant losses in recent years, and their impact on MassHealth costs.
The advisory group will consider all cost-drivers and potential savings for MCOs. It will also look at the costs of rare disease treatment medications and examine barriers to increasing adoption of alternative payment methods. Thirty-seven percent of MassHealth members receive services via Medicaid MCOs; the finances of such groups are often challenged by expensive new treatments.
“I’m concerned about the pressure MassHealth and their partner Medicaid MCOs face in today’s healthcare market,” said DeLeo. “I believe the MCO advisory group will bring together members of the hospital, healthcare, insurer and bio-innovation communities to find creative solutions that balance our need to address costs while maintaining Massachusetts’s standing in the healthcare and life sciences sectors.”
“As I visit hospitals around the state and meet providers and insurers, I am hearing much about the cost pressure MassHealth stakeholders face,” said Representative Jeffrey Sanchez, the House Chair of the Joint Committee of Healthcare Financing. “The cost of rare disease treatment is often cited by Medicaid MCOs, and we need to devise comprehensive solutions in keeping with the bold vision of our universal access to healthcare and wisdom of our efforts at cost containment in recent years.”
“It’s important that we get everyone to the table to address this issue,” said Representative Garrett Bradley, the House’s Second Assistant Majority Leader. “As costs continue to rise, it has become very clear that we need to be creative in finding alternative solutions that benefit consumers and patients.”
The 13-member panel will include seven House members as well as six industry representatives: one representative of the Massachusetts Association of Health Plans, one member from a health plan serving a disproportionate share population, one member of the Massachusetts Hospital Association, a member from a hospital system that operates four disproportionate share hospitals, a member of the Massachusetts Council of Community Hospitals and a member from the Massachusetts Biotechnology Council. The commission will begin meeting later this month and plans to issue legislative recommendations to the House by October 1.
