Healthcare Costs Gone Wild

State experts are preparing for a report due this spring to reflect an enormous one-year surge in health care spending across Massachusetts, a shift that might prompt reassessment of cost controls amid the upheaval inflicted by the COVID-19 pandemic.

Health Policy Commission Executive Director David Seltz said Wednesday the panel charged with monitoring and controlling health care spending growth will "need to evolve our approach" for the latest batch of annual data.

In March, the Center for Health Information and Analysis will publish its latest annual report examining total statewide health care spending in 2021 and how it changed from 2020. Seltz said he expects the report to reflect a dramatic rebound in expenses after the first nine months of the pandemic prompted an unusual drop.

"Given what we know about the decrease in spending that occurred in 2020 due to the pandemic, we fully anticipate that that report is going to show a very high increase, percentage increase, in health care spending. It could be as high as double digits," Seltz said at an HPC board meeting Wednesday. "This will really require us to think about: how are we going to think about holding payers and providers accountable in a time period that has so much underlying disruption in the data?"

The last annual report CHIA published in March found total health care expenditures dropped 2.4 percent in 2020 to $62.6 billion, or $8,912 per capita. That was the first year-over-year decline CHIA observed since a 2012 law created the agency.

Officials have said they viewed the 2020 data as an outlier and remained focused on addressing rising health care costs, which in the most recent years before the pandemic outpaced the state's targets for keeping spending within a manageable range. 

AND, in other Healthcare Topics...

Health Policy Commission Cools on Ordering Improvements

A year after flexing a previously unused regulatory muscle to order cost containment steps at Mass General Brigham, the Health Policy Commission opted against requiring performance improvement plans for any provider, insurer or other health care entity in the latest annual cycle.

Officials announced during an HPC board meeting Wednesday that, in a closed-doors executive session last month, the panel elected not to pursue action against any entity referred to it in 2022 for potentially excessive cost growth.

"This decision really reflects the fact that we had previously reviewed and acted on preliminary '18-'19 trends, the '19-'20 trends were disrupted by the pandemic, as well as a recognition of the ongoing challenges facing the health care system and a desire to avoid placing additional administrative burdens on entities at this time," Kara Vidal, the HPC's director of health system planning and performance, said.

An HPC spokesperson said the commission reviewed 51 entities in the latest annual cycle as it weighed pursuing performance improvement plans, or PIPs.

Healthcare Growing Out of Reach for Many

More than a third of Massachusetts residents experienced difficulty accessing necessary health care in 2021, a growing share as statewide spending on primary care dropped and the aging provider workforce contracted, according to newly published data.

Shedding new light on a facet of the state's health care system where some policymakers have pushed unsuccessfully for new investment, the Center for Health Information and Analysis on Wednesday published its first-ever dashboard highlighting primary care finance, capacity, access and utilization data points.

The analysis found 33.9 percent of Bay Staters in 2021 reported challenges obtaining "necessary health care" in the past 12 months, an increase of 1.5 points over the rate two years earlier.

Other measurements of access to care showed similar signs of strain.

In 2021, 88.1 percent of Massachusetts residents reported that they had a usual source of care, down from 90.6 percent in 2019. The share of commercial patients between 50 and 75 years old who received a recent screening for colorectal cancer dropped from 80.2 percent in 2018 to 74.6 percent in 2020.

Some of the trends reflect the impact of the COVID-19 pandemic, which prompted many people to delay seeking care or addressing health needs.

CHIA's dashboard, produced alongside Massachusetts Health Quality Partners, also found that fewer medical professionals are offering primary care. In 2018, about 30.4 percent of Massachusetts physicians practiced in primary care, and that rate dipped to 29.8 percent in 2019 and 2020.

All Reports from State House News Service