Voices in Healthcare

Hope everyone is enjoying MHA's new website and blog. I encourage you to post comments! The goal of Voices in Healthcare is to foster discussion, and believe me, there's plenty to talk about.

Federal and state reform, H1N1, cost and quality issues, the economic importance of healthcare to our state and national economies... You can't turn around these days without running into an important healthcare issue.

The hottest topic continues to be payment reform. Since the Massachusetts Special Commission on the Health Care Payment System issued its recommendations over the summer, there has been a lot of pressure from some sectors to act on the proposals, despite the fact that the Commission made its recommendations purposefully broad.

My ongoing discussions with providers clearly show that most Massachusetts hospitals favor changing the payment system away from the traditional (and broken) fee for service model, toward a more comprehensive and streamlined system that results in efficient, coordinated and collaborative care delivery across the board. But just like tackling a new program on my elliptical machine ultimately affects all of the muscles I use during a workout, so too any change to how providers are paid will have repercussions for the entire healthcare delivery system, up to and including patients. Even when we know that something is theoretically good for us and is the right thing to do, it's a normal reaction to consider the risks along with the benefits, and figure out the best way to make needed improvements while avoiding serious injury.

I'm encouraged that our hospitals are contemplating what they need to do to be successful in an environment that is not predominantly fee for service. Meanwhile, MHA is reaching out to other key stakeholders including legislative leaders and Administration officials to find common ground regarding workable efforts to move the reform effort forward. MHA's October white paper outlined hospitals' most serious concerns about implementing payment reform and helped to inform the dialogue. I sure hope you've already read it - and we'll soon be issuing several additional papers on these "foundational" issues and suggestions for how best to resolve them. So stay tuned, watch this space, and join the debate! Your perspective is really valuable.