Friday, May 04, 2012

Hey, Romneycare may get a 'death panel'

Not really. But legislation is afoot to create an IPAB (Independent Payment Advisory Board) on steroids -- Trenbolone to the ACA's Creatine. The WSJ's Jennifer Levitz and Anna Matthews report:
Key state legislative leaders unveiled a bill Friday that proposes setting a target for the rate at which overall health spending should rise—a step that would once again put the state in the forefront of efforts to remake the American health-care system...

The rate of growth in spending on health—initially set to parallel the growth of the state's overall economy as measured by its gross domestic product—would be enforced by a regulatory authority. Health-care providers and health plans that the regulator found to be pushing spending above the goal would have to submit improvement plans to bring expenses down. Institutions would still be able to challenge their findings by showing extenuating circumstances, such as necessary improvements to the system, that kept expenses up. The authority, which will include government, industry and consumer representatives, would ultimately have the power to force them to renegotiate their contract.

The federal IPAB, by contrast, can merely send a package of cost-control reforms to Congress, which would give it an up-or-down vote, rather than putting the onus on providers or insurers (e.g., Medicare itself, or Medicare Advantage plans, since IPAB oversees Medicare only).  The target inflation rate is stricter in the Massachusetts legislation, too.

Additionally, the pending legislation would try, like the ACA but apparently with more sweeping incentives, to move healthcare providers off fee-for-service:

The bill from House Speaker Robert DeLeo and state Rep. Steven Walsh, co-chairman of the legislature's Joint Committee on Health Care Financing—and two key Democrats in a Democratic-controlled legislature—would take another major step by forcing changes in how insurers pay hospitals and other health-care providers, moving them away from the traditional method of fees for each service. It would require health plans to give greater price transparency to consumers, so people would know how much they would pay out of their pockets for particular medical services
 Go ahead, Romney -- denounce Romneycare II as "government-run healthcare." This is a bid for the state to exercise much more sweeping top-down cost control than the ACA does.

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