That was the general theme of a panel discussion hosted by Associated Industries of Massachusetts on Tuesday, featuring leaders from four distinct areas of the health care sector.
Audrey Morse Gasteier, executive director of the Massachusetts Health Connector, kicked things off by warning of the challenges ahead, particularly with the anticipated annual loss of some $3.5 billion in federal funds for subsidized coverage.
“The scope of these changes is quite difficult to wrap one’s head around,” she said. “It’s so important that the business community is at the table.”
Health care costs were already a growing concern, even before the cuts from Washington created a new level of crisis for the state. Morse Gasteier implored those in the room to come together on solutions, much like what happened 20 years ago. (The AIM event, at PwC’s Seaport office, took place one day after several former governors joined with Governor Maura Healey at Faneuil Hall to celebrate the 20th anniversary of “Romneycare.”)
Emerson Hospital CEO Christine Schuster told the AIM members that the only way to fix what’s ailing the state’s health care system is for the various constituencies to be willing to give up something in favor of the greater good.
That will be easier said than done, given the tense relationship between insurers and hospitals, not to mention pharmaceutical and med-device companies.
Schuster also noted that broader inflation is playing a role, with employees telling her that they face longer commutes because of housing prices, bigger fuel bills as a result, as well as jaw-dropping prices at the supermarket, like $7.99 for a mid-sized jar of Hellman’s mayonnaise. And Schuster lamented the increased competition from privately funded physicians’ groups that can cherry-pick the most profitable procedures and services for themselves.
Bob Donnelly, senior director of health policy at Johnson & Johnson, suggested regulators and lawmakers take a closer look at the pharmacy benefit managers that take a cut out of manufacturers’ coupons, driving patients’ costs up.
At Blue Cross Blue Shield of Massachusetts, chief executive Sarah Iselin has been trying to draw a hard line, limiting hospital systems’ average price increases to 3.6 percent a year, the state’s health care inflation benchmark. But she said this effort at cost control has been partially hampered by hospitals’ use of AI to “upcode,” to find additional reasons to charge insurers for a patient’s visit.
Iselin also wants to see more “global payment” arrangements, in which health care providers get a fixed amount to cover most of a patient’s care, as well as more shifting of care out of pricey Boston hospitals to their less expensive suburban affiliates.
“I have more optimism, given that this is a relatively small community [and] we all know each other,” Iselin concluded, “that we will be able to figure this out again.”
This is an installment of our weekly Bold Types column about the movers and shakers on Boston’s business scene.
Jon Chesto can be reached at jon.chesto@globe.com. Follow him @jonchesto.