Boston — Sen. Adam G. Hinds, D-Pittsfield, announced Friday the Massachusetts Senate passed sweeping healthcare reform legislation S.2202, An Act Furthering Health Empowerment and Affordability by Leveraging Transformative Health Care. The HEALTH Act, passed by a vote of 33-6, focuses on both short- and long-term goals on how to fix the state’s health care system to lower costs, improve outcomes and maintain access. The legislation is the result of a year-long effort by the Special Senate Committee on Health Care Cost Containment and Reform addressing Massachusetts’ health care system by analyzing the best practices in other states and engaging stakeholders in a series of meetings.
The Senate has continued to push for reforms to the current system through diligent research, stakeholder engagement and legislation. The working group of senators, with the logistical support of the Milbank Memorial Fund, spent the last year meeting with officials from seven states, health care experts and stakeholders to examine best practices while lowering costs and improving outcomes.
During Thursday’s debate, Hinds led a bipartisan effort to secure language updating volunteer ambulance service staffing requirements in rural communities. Current law and regulations state that, when transporting a patient receiving care at either the paramedic level of advanced life support or the non-paramedic level of basic life support, an ambulance must be staffed with two emergency medical technicians. Hinds’ amendment, based on pending legislation he has sponsored with Rep. Paul Mark, D-Peru, allows volunteer ambulance services in rural communities to transport a patient receiving care at the non-paramedic level of basic life support to staff the ambulance with one EMT and one first responder.
Updating this requirement to meet the needs and staffing realities of small rural volunteer ambulance departments is a major priority for many towns in Hinds’ western Massachusetts district. The senator worked with many local stakeholders including Rural Commonwealth, volunteer ambulance services, municipal officials, hospital administrators and the Department of Public Health to finalize the amendment language, which was passed unanimously.
The bill implements more effective care delivery, such as telemedicine and mobile integrated health, to reduce emergency room visits and expand provider versatility while also addressing price variation between larger hospitals and their smaller community-hospital counterparts.
A recent study by the University of California Davis Health system estimates that “by using telemedicine for clinical appointments and consultations, its patients avoided travel distances that totaled more than 5 million miles. Those patients also saved nearly nine years of travel time and about $3 million in travel costs.”
The bill aims to reduce hospital re-admissions and emergency department use through mobile integrated health and telemedicine as well as expanding access to behavioral health. The Massachusetts Health Policy Commission has estimated that 42 percent of all emergency department visits are avoidable.
S.2202 aims to tackle provider price variation, the variation between providers for similar procedures, by implementing a floor for providers while also setting a benchmark for hospital spending. If hospitals exceed the benchmark, the state will implement fines or penalties on those institutions.
Post-acute care in an institutional setting and long-term care and supports cost the state an estimated $4.7 billion in 2015, a major cost driver for MassHealth. The bill increases transition planning for patients into community settings and strengthens coordination among providers.
Pharmaceutical costs have been a driver of increased health care costs for a number of years. The Center for Health Information and Analysis reported a 6.4 percent growth in pharmaceutical spending in 2016. The bill implements greater oversight and transparency in drug costs and encourages Massachusetts to enter into bulk purchasing arrangements, including a multistate drug-purchasing consortium like other states, to lower costs and protect consumers.
The legislation encompasses the whole system from Medicaid to the commercial market, addresses price variation, increases price transparency for consumers, leverages better federal funding opportunities and expands scope of practice for many practitioners including dental therapists, optometrists, podiatrists and nurse anesthetists.
The bill will now move to the House of Representatives for consideration.