BOSTON (AP) — State Senate leaders are unveiling their version of a health care payment bill they say will help hold the line on soaring costs while dramatically updating how health care is delivered.
The Senate bill seeks to peg increases in health care spending to the growth in the state economy. Senate leaders say their plan will result in more than $150 billion in savings over the next 15 years.
To help rein in spending, the Senate bill creates a Health Care Quality and Finance Authority, governed by a board of state officials, health policy experts and business, consumer and labor representatives. The goal of the authority is to set annual health care cost goals.
From 2012 to 2015, the goal is to keep the projected growth of health care spending equal to the gross state product plus half a percent. From 2016 to 2026, the goal is to keep health care cost growth equal to the projected growth in the gross state product. After 2027, the goal is to keep health care spending equal to the projected growth in the gross state product plus 1 percent.
The new authority also will create a certification program for accountable care organizations, health care networks that take coordinated approaches to medicine so risks like high blood pressure and elevated blood sugar are managed better and patients get help leading healthier lifestyles.
The standards for certification will "reflect a high commitment by the provider organization to reduce cost growth, improve quality and coordinate care," the bill says. Organizations that win certification will be given preference in the contracting of state-funded health care programs.
There already are five accountable care organizations in the state.
The release of the Senate bill follows the unveiling last Friday of the House version of the bill. The Senate expects to debate its bill next week.
Senate President Therese Murray, a Democrat, has said she expects passage of a health care overhaul by July 1.
Lawmakers have been grappling for ways to slow spiraling costs since 2006, when then-Gov. Mitt Romney, a Republican, signed the state's landmark health care law, which dramatically expanded access to health coverage.
Massachusetts now has the highest rate of insured residents in the nation — more than 98 percent of the population. But soaring premiums and other health care costs have threatened to undermine the long-term fiscal stability of the law.
The Senate bill also would:
— Require the state's Medicaid program, its employee health care program and all other state-funded health care programs to transition to new health care payment methods by 2014.
— Set new transparency tools to let consumers make health care purchasing decisions based on comparative cost and quality, including knowing up-front what the expected cost will be for each service.
— Spend $100 million to accelerate the statewide adoption of electronic health records by 2015.
— Develop a process to track price variation among hospitals and health care providers and establish a commission to determine the factors contributing to price variation.
The House bill also is designed to even out disparities in the costs of hospital services by requiring hospitals that charge more than 20 percent above the state median price for a service to pay a 10 percent surcharge into a fund to help support hospitals serving the poor and most vulnerable.
The Senate bill tries to grapple with current trends that suggest the financial cost to the Massachusetts economy from preventable forms of chronic diseases could reach $62 billion by 2023. To help reduce that cost, the Senate plan sets aside $100 million over the next five years to community-based prevention, public health and wellness efforts.
The Senate bill agrees with the House bill on some key malpractice proposals including letting doctors apologize for mistakes and creating a 180-day cooling-off period to give both sides a chance to settle.
House leaders said their bill could save the Massachusetts economy $160 billion in unnecessary health care costs over the next 15 years while lowering family premiums by nearly $2,000 annually over the next five years.
Democratic Gov. Deval Patrick first proposed in February 2010 that the state move toward a so-called global payment system to replace the fee-for-service approach.
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