By Andy Metzger | State House News Service October 5, 2015
BOSTON -- Citing its strong "culture," Gov. Charlie Baker on Monday praised Lowell General Hospital as a model worth studying as policymakers and industry leaders confront a difficult health-care marketplace.
Speaking at the annual hearings of the state Health Policy Commission, Baker said Lowell General's success might have more to do with its decades-long run of high quality and low cost than other systemic changes. Baker also said he would be "aggressive" about adding transparency to the market.
Baker said the state should figure out how to better support family caregivers, and highlighted Lowell General as an institution that has had strong quality and kept costs in check since Baker's time in the Weld administration.
The governor credited "the culture and the approach" of the Lowell hospital more than the various payment models, and he said its success is worth studying.
"I've always been a big believer that if you find somebody who's doing something well, the best thing you can do is figure out what it is they're doing and then celebrating it," Baker said.
BOSTON -- Citing its strong "culture," Gov. Charlie Baker on Monday praised Lowell General Hospital as a model worth studying as policymakers and industry leaders confront a difficult health-care marketplace.
Speaking at the annual hearings of the state Health Policy Commission, Baker said Lowell General's success might have more to do with its decades-long run of high quality and low cost than other systemic changes. Baker also said he would be "aggressive" about adding transparency to the market.
Baker said the state should figure out how to better support family caregivers, and highlighted Lowell General as an institution that has had strong quality and kept costs in check since Baker's time in the Weld administration.
The governor credited "the culture and the approach" of the Lowell hospital more than the various payment models, and he said its success is worth studying.
"I've always been a big believer that if you find somebody who's doing something well, the best thing you can do is figure out what it is they're doing and then celebrating it," Baker said.
Lowell General CEO Normand Deschene, who attended the hearings, said he is honored that Baker singled out LGH, and credited the hospital's employees and focus on putting patients first.
"I think it's a total team effort," Deschenes said Monday night. "Our mission is to put patients first in everything we do."
Deschene said that, moving forward, there are still challenges of keeping the hospital in great shape, especially since LGH is paid significantly less than some other hospitals by insurance companies and other payers.
"The disparity amongst payers and providers is significant, so we always face the challenge of having to do more with less," he said.
Laying out their visions of the health-care marketplace, Baker and a Harvard University policy expert offered sometimes varying perspectives on costs trends.
While extolling the importance of competition, Amitabh Chandra, professor of social policy and director of health-policy research at Harvard's Kennedy School of Government, included price transparency with management of population health, and wellness programs as ideas that should elicit skepticism.
"We have to be extremely skeptical of all the something-for-nothing remedies," Chandra told the commission after Baker gave testimony. "So we have to be extremely skeptical about the benefits of consumer price transparency, of wellness, population health, in saving money in the next five, 10 years."
Baker and Chandra spoke at length to help launch the hearings where policymakers and industry officials discussed drivers behind 2014's 4.8 percent growth in health costs, outpacing a 3.6 percent benchmark.
Baker, who steered Harvard Pilgrim Health Care away from financial ruin after serving in state government, said his belief that prescribers had not been suitably careful about narcotics made him question other prescription practices.
"Since 80 percent of the people who end up addicted to heroin started on prescription pain meds, and the number of prescriptions that have been written for opioids have gone up five-fold over the course of the past 15 years," Baker said. "My own view is my colleagues in the health-care world have been not as aggressive about understanding the downsides associated with many of these medications as they've been about understanding and appreciating the upside."
Baker noted the important role biotech and other health-care companies play in the local economy, while Chandra said, "Health care is not a jobs program."
"We specialize in high-quality care and innovation, and economic expansion in those areas means more jobs and more resources pumped into our local economy," House Speaker Robert DeLeo said.
Energy and housing costs tend to come up in his conversations with others more often than health-care costs, Baker said. Baker said Medicare's fee-for-service undergirds how people in the health market view the dollar-value of procedures, even as groups move toward more holistic approaches to compensating health care providers, such as accountable care organizations.
"If you talk to almost anybody in the provider community, however it is they get paid by anybody, they usually convert whatever that is into what they call a Medicare fee-for-service equivalent, and that's pretty much the way people keep score," Baker told reporters later in the day. "Medicare has historically paid more for technology and for procedures more than it's paid for time, which is what primary care's sort of always been about."
In general, accountable care organizations accept a lump sum payment to manage the health needs of a population of insured individuals.
While he cast skepticism at global payments as a means of raising quality and lowering cost, saying it is built on a "fee-for-service chassis," Chandra raised the idea of paying a provider per health episode.
"This will take us a very, very long time to get right," Chandra said of new payment models.
Chandra said health costs track with gross domestic product, which is on the rise, and contemplated using a tiered system -- currently used by insurers to classify providers -- for procedures, so that expensive, potentially useless procedures would not receive the same coverage.
Chandra described the costs associated with proton beam therapy for prostate cancer as "the Death Star of all medical technologies, because nothing so big and perhaps so useless has ever been invented before."
Lowell Sun staff writer Robert Mills contributed to this report.
"I think it's a total team effort," Deschenes said Monday night. "Our mission is to put patients first in everything we do."
Deschene said that, moving forward, there are still challenges of keeping the hospital in great shape, especially since LGH is paid significantly less than some other hospitals by insurance companies and other payers.
"The disparity amongst payers and providers is significant, so we always face the challenge of having to do more with less," he said.
Laying out their visions of the health-care marketplace, Baker and a Harvard University policy expert offered sometimes varying perspectives on costs trends.
While extolling the importance of competition, Amitabh Chandra, professor of social policy and director of health-policy research at Harvard's Kennedy School of Government, included price transparency with management of population health, and wellness programs as ideas that should elicit skepticism.
"We have to be extremely skeptical of all the something-for-nothing remedies," Chandra told the commission after Baker gave testimony. "So we have to be extremely skeptical about the benefits of consumer price transparency, of wellness, population health, in saving money in the next five, 10 years."
Baker and Chandra spoke at length to help launch the hearings where policymakers and industry officials discussed drivers behind 2014's 4.8 percent growth in health costs, outpacing a 3.6 percent benchmark.
Baker, who steered Harvard Pilgrim Health Care away from financial ruin after serving in state government, said his belief that prescribers had not been suitably careful about narcotics made him question other prescription practices.
"Since 80 percent of the people who end up addicted to heroin started on prescription pain meds, and the number of prescriptions that have been written for opioids have gone up five-fold over the course of the past 15 years," Baker said. "My own view is my colleagues in the health-care world have been not as aggressive about understanding the downsides associated with many of these medications as they've been about understanding and appreciating the upside."
Baker noted the important role biotech and other health-care companies play in the local economy, while Chandra said, "Health care is not a jobs program."
"We specialize in high-quality care and innovation, and economic expansion in those areas means more jobs and more resources pumped into our local economy," House Speaker Robert DeLeo said.
Energy and housing costs tend to come up in his conversations with others more often than health-care costs, Baker said. Baker said Medicare's fee-for-service undergirds how people in the health market view the dollar-value of procedures, even as groups move toward more holistic approaches to compensating health care providers, such as accountable care organizations.
"If you talk to almost anybody in the provider community, however it is they get paid by anybody, they usually convert whatever that is into what they call a Medicare fee-for-service equivalent, and that's pretty much the way people keep score," Baker told reporters later in the day. "Medicare has historically paid more for technology and for procedures more than it's paid for time, which is what primary care's sort of always been about."
In general, accountable care organizations accept a lump sum payment to manage the health needs of a population of insured individuals.
While he cast skepticism at global payments as a means of raising quality and lowering cost, saying it is built on a "fee-for-service chassis," Chandra raised the idea of paying a provider per health episode.
"This will take us a very, very long time to get right," Chandra said of new payment models.
Chandra said health costs track with gross domestic product, which is on the rise, and contemplated using a tiered system -- currently used by insurers to classify providers -- for procedures, so that expensive, potentially useless procedures would not receive the same coverage.
Chandra described the costs associated with proton beam therapy for prostate cancer as "the Death Star of all medical technologies, because nothing so big and perhaps so useless has ever been invented before."
Lowell Sun staff writer Robert Mills contributed to this report.
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