grew by 5.7 percent<\/a> between 2023 and 2024, while the benchmark was set at 3.6 percent, a Center for Health Information and Analysis report found last month. Affordability woes are worsening, and more Bay Staters are choosing to delay care due to cost concerns.<\/p>\nThe state is at a \u201cbreaking point of complete unaffordable health care,\u201d said state Representative John Lawn, co-chair of the Joint Committee on Health Care Financing.<\/p>\n
\u201cWe are all in this together and unless we solve this, we\u2019re going to have very dire consequences for our health care market and our ability to provide affordable and accessible health care,\u201d Lawn told hearing attendees.<\/p>\n
As an \u201cex-CEO of a medical institution,\u201d Health and Human Services Secretary Kiame Mahaniah acknowledged he tried to balance tough budgets by embracing \u201chigher paid things.\u201d He led the Lynn Community Health Center for six years and previously was chief medical officer at North Shore Community Health.<\/p>\n
\u201cThe incentive was to figure out what I am doing that has the highest margin possible so I can keep paying my employees?\u201d Mahaniah said. \u201cSo it\u2019s not always like a nefarious, sort of price-gouging things. Sometimes, it\u2019s just sheer survival, right?\u201d<\/p>\n
Auerbach described the dynamic as a \u201cfault of pricing in the system,\u201d which can be hard for health care systems to \u201cresist\u201d as they weigh which treatment options are more profitable. That outlook explains why hospitals are closing labor and delivery units because they\u2019re a \u201cmoney loser,\u201d Mahaniah said.<\/p>\n
State Senator Cindy Friedman, the Senate\u2019s health care point person, said policymakers must understand where health care dollars are flowing as Massachusetts braces for federal funding cuts under the One Big Beautiful Bill Act.<\/p>\n
\u201cAre they being invested in health care services and workforce that our residents need and deserve, or are our dollars being hid in systems used for profit instead of care, or being put in entities that are costing the most but offering the least?\u201d Friedman asked at the start of the hearing.<\/p>\n
Liz Leahy, senior vice president of advocacy and engagement at the Massachusetts Association of Health Plans, said administrative spending is not driving health care costs. She instead pointed to the cost of care, including across hospital outpatient settings and pharmaceutical spending.<\/p>\n
\u201cChemo oncology drugs are one of the fastest growing drivers of cost, now totaling more than $3 billion annually,\u201d Leahy said. \u201cAnd these costs reflect both the price of the drug, which is set by the drug manufacturers, and the price of the site of care set by the providers. And neither of those price components are meaningfully constrained today.\u201d<\/p>\n
Leahy said hospitals, providers, and pharmaceutical manufacturers must work together and be held accountable. Insurance Commissioner Michael Caljouw pointed out that insurers are \u201cuniquely in the middle\u201d of negotiating prices with those other major players.<\/p>\n
\u201cWe\u2019ve seen rapid consolidation of health care systems,\u201d Leahy replied. \u201cI won\u2019t argue whether it\u2019s good or bad, but I will let you know that that has significantly reduced the negotiating leverage of health plans across the country and here in Massachusetts.\u201d<\/p>\n
Retailers Association of Massachusetts president Jon Hurst said Wednesday marks the biggest insurance renewal date of the year for small businesses. A recent member survey found the average premium increase was 13.6 percent, he said.<\/p>\n
Hurst said \u201csomething is wrong\u201d with the state\u2019s benchmark and the individual health insurance mandate, which top elected state officials plan to celebrate this month on its 20th anniversary.<\/p>\n
\u201cAs we have stated for many years, small employers need fairness and help on controlling health care and insurance costs,\u201d Hurt said in written testimony, as he pointed to an exodus of small group employers leaving the fully insured marketplace and turning to self-insured or partially-self funded plans. The trend, he said, is \u201can attempt to \u201cmitigate the cost of nearly 60 state mandates.\u201d<\/p>\n
\u201cEstimates put state mandates and assessments at 17-24 percent of a fully insured small business\u2019s premium,\u201d Hurst added. \u201cFor a $47,000 family policy \u2014 unfortunately a very real number this year \u2014 that\u2019s $8,000-$11,000 in state mandates.\u201d<\/p>\n
The HPC board is slated to vote on setting the benchmark on April 16. A decision to change the target could trigger another hearing before the Joint Committee on Health Care Financing.<\/p>\n","protected":false},"excerpt":{"rendered":"\u201cWe see shifts toward higher priced prescription drugs, shifts toward higher-cost imaging modalities, shifts toward higher-cost settings of…\n","protected":false},"author":2,"featured_media":562693,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[8731,137574,3235,97,252,253],"class_list":["post-562692","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health-care","tag-boston","tag-brigham-and-womens-hospital","tag-emergency","tag-health","tag-health-care","tag-healthcare"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/562692","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=562692"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/562692\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/562693"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=562692"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=562692"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=562692"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}