{"id":150838,"date":"2025-11-24T20:29:09","date_gmt":"2025-11-24T20:29:09","guid":{"rendered":"https:\/\/www.newsbeep.com\/il\/150838\/"},"modified":"2025-11-24T20:29:09","modified_gmt":"2025-11-24T20:29:09","slug":"blue-cross-ceo-says-shes-taking-cost-controls-seriously-in-hospital-negotiations","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/il\/150838\/","title":{"rendered":"Blue Cross CEO says she\u2019s taking cost controls seriously in hospital negotiations"},"content":{"rendered":"

Governor Maura Healey got the most applause from the retailers in the room a year ago when she promised<\/a> to tackle the high costs of health care.<\/p>\n

This time around, at the 2025 annual meeting of the Retailers Association of Massachusetts last week, it was Sarah Iselin\u2019s turn to make a similar pledge.<\/p>\n

As chief executive of the state\u2019s largest health insurer, the nonprofit Blue Cross Blue Shield of Massachusetts, Iselin has as much power to curb health care costs as the governor, if not more. And Iselin isn\u2019t afraid to wield it. She put hospital systems on notice over the summer<\/a> that as contracts come up, she would hold them to the medical inflation cap set by the state Health Policy Commission \u2014 3.6 percent today.<\/p>\n

Iselin, in a Q&A session with RAM president Jon Hurst, pointed to the first high-profile clash caused by this stance, over renewing a huge contract with the UMass Memorial Health system, affecting nearly 200,000 members. (The two sides reached an agreement<\/a> on a new three-year contract earlier this month.)<\/p>\n

\u201cThat [3.6 percent] benchmark, we\u2019re taking it seriously,\u201d Iselin said, speaking to the crowd of RAM members at Bentley University in Waltham. \u201cWe\u2019re going to hold our unit prices to that benchmark, on average.\u201d<\/p>\n

Hospital operators, she said, generally argue the 3.6 percent benchmark is too low. Many hospital systems, including UMass Memorial, have been contending with skyrocketing labor costs since the COVID-19 pandemic, particularly with regard to hiring nurses.<\/p>\n

\u201cThat is the tension we\u2019re going to have to navigate,\u201d Iselin told the crowd. \u201c[But] we\u2019re at a point where people can\u2019t afford to pay more.\u201d<\/p>\n

She cited one report that showed Massachusetts ranked 48th <\/a>in the country for health care costs paid for by employers.<\/p>\n

\u201cThat\u2019s not the direction you want to go in,\u201d Iselin said. \u201cThe bad news is, honestly, as I look out over the next couple of years, I don\u2019t see it slowing down.\u201d<\/p>\n

Hurst lamented that state lawmakers didn\u2019t focus enough on costs when they first adopted the so-called Romneycare health care reforms in 2006. The cost control reforms that created the Health Policy Commission<\/a> came later, in 2012<\/a>.<\/p>\n

Hurst said he was disappointed to see an employer representative missing from the HPC in favor of hospital and biotech industry reps, in a reorganization that took effect<\/a> over the past summer.<\/p>\n

\u201cAre we really serious about dealing with health care costs in this state, or are we sweeping it under the rug?\u201d Hurst asked Iselin.<\/p>\n

She responded: \u201cWe\u2019re serious about it.\u201d<\/p>\n

She ended on an encouraging note, saying she remains optimistic that policy makers can come up with a creative solution to the rising costs.<\/p>\n

\u201cEach of us will likely have to give something up, us as health plans included,\u201d Iselin said. \u201cThe more we hear from those ultimately [paying] the bills, employers and consumers, the better choices we will make.\u201d<\/p>\n

This is an installment of our weekly Bold Types column about the movers and shakers on Boston\u2019s business scene.<\/p>\n

Jon Chesto can be reached at jon.chesto@globe.com<\/a>. Follow him @jonchesto<\/a>.<\/p>\n