Valeant’s Drug Price Strategy Enriches It, but Infuriates Patients and Lawmakers
By ANDREW POLLACK and SABRINA TAVERNISE
J. Michael Pearson has become a billionaire from his tough tactics as the head of the fast-growing Valeant Pharmaceuticals International.
And consumers like Bruce Mannes, a 68-year-old retired carpenter from Grandville, Mich., are facing the consequences.
Mr. Mannes has been taking the same drug, Cuprimine, for 55 years to treat Wilson disease, an inherited disorder that can cause severe liver and nerve damage. This summer, Valeant more than quadrupled its price overnight.
Medicare will now have to cover about $35,000 for the 120 capsules he takes each month, and Mr. Mannes will have to pay about $1,800 a month out of pocket, compared with about $366 he paid in May.
“My husband will die without the medicine,” said his wife, Susan, who is now working a second part-time job to help pay for health care. “We just can’t manage another two, three thousand dollars a month for pills.”
Cuprimine is just one of many Valeant drugs whose prices have spiked as part of the company’s concerted strategy, which has richly rewarded its investors and made it one of Wall Street’s most popular health stocks.
But Valeant’s habit of buying up existing drugs and raising prices aggressively, rather than trying to develop new drugs, has also drawn the ire of lawmakers and helped stoke public outrage against the growing trend of higher and higher drug prices imposed by big drug companies. This year alone, Valeant raised prices on its brand-name drugs an average of 66 percent, according to a Deutsche Bank analysis, about five times as much as its closest industry peers.
Some presidential candidates have also seized on the issue. Hillary Rodham Clinton, who is seeking the Democratic nomination, called for efforts to control “price gouging” after a public outcry over the actions of Turing Pharmaceuticals, which abruptly increased the price on a drug to $750 a tablet from $13.50.
And last week, Democrats on the House Committee on Oversight and Government Reform demanded that Valeant be subpoenaed for information about big price increases on two old heart drugs that the company acquired in February.
Valeant’s High-Price Drug Strategy
Talk about a reversal of fortune.
Until recently, investors were positively star-struck by drug companies that could raise prices indiscriminately, letting their patients struggle to pay the freight. Lauded for a laserlike focus on shareholder returns, companies like Valeant Pharmaceuticals International, a multinational specialty drug company based in Quebec, received high marks and even higher valuations from besotted shareholders.
Now, however, investors are beginning to see the peril in such a business model. Sure, price jumps may generate earnings and stock gains, but when the enrichment of a few comes at the cost of many, unwanted scrutiny often follows.
Hijacked drug prices blasted to the forefront two weeks ago after a report in The New York Times told the story of how Martin Shkreli, the chief executive of the privately held Turing Pharmaceuticals, bought Daraprim, a 62-year-old infectious disease drug, and immediately raised its price to $750 from $13.50 a tablet.
When a firestorm ensued, Mr. Shkreli accurately noted that his was not the only company to acquire a drug and then send its price into the stratosphere.
The spotlight soon fell on Valeant, which generated $8.25 billion in revenue last year, up 43 percent from 2013. Among its well-known drugs is Ativan, a treatment for anxiety.
Valeant caught the eye of Congress this year after it increased the price of two heart medications it had just bought the rights to sell: Nitropress and Isuprel. Valeant raised the price of Nitropress 212 percent and Isuprel 525 percent.
Democratic members of the House Committee on Oversight and Government Reform, led by Elijah Cummings, the Maryland Democrat who is its ranking member, have been investigating rocketing drug prices. This year they asked Valeant to provide documents about the increases; it declined.
So last Monday, 18 Democratic members of the committee asked its chairman to subpoena Valeant for those documents.
It is unclear whether the subpoena will be issued. But Valeant’s stock slid 16.5 percent on the news. It recovered somewhat later in the week, but it has lost more than 30 percent since its August high closing price of $262.52.
With the stock plummeting, J. Michael Pearson, Valeant’s chief executive, sent a letter to reassure employees. In it, he rejected investor concerns that the company’s strategy relied on big price increases. He noted that half of the company’s sales came from domestic and international businesses in which it had realized small or no net price increases.
Valeant is “committed to focusing on our key stakeholders while delivering consistently high performance,” its website states.
Appeal House v. Burwell
By Irvin B. Nathan October 4
The writer, a senior counsel at the law firm of Arnold & Porter, was general counsel of the U.S. House of Representatives from 2007 to 2010.
As general counsel of the House of Representatives in 2008, I brought the first successful lawsuit by the chamber against the executive branch. But I do not celebrate the recent House victory in federal District Court allowing it to proceed with its ill-considered litigation over appropriations under the Affordable Care Act, known colloquially as Obamacare. If not overturned, this decision could have seriously adverse consequences for our democracy, as well as for millions of needy Americans.
The suit that I brought on behalf of the House sought the enforcement of House Judiciary Committee subpoenas issued for the testimony of former White House counsel Harriet Miers and for documents in the custody of the White House chief of staff. The White House refused to comply with the subpoenas, claiming that such high-level administration officials were “absolutely immune” from House subpoenas. The District Court found that this was a purely legal issue, which the courts were uniquely situated to resolve.
Enforcement of subpoenas is routine fare for the courts. And in the Miers case, the court found that the House had no effective recourse other than a lawsuit, that the parties were at an impasse and that a ruling from the court could help the House perform its constitutional function to provide oversight of the executive.
The current case, House of Representatives v. Burwell , is quite different. In this dispute, the House claims that subsidies the executive branch is paying to insurance companies to provide health insurance for low-income individuals have not been properly appropriated by Congress. Not only is it unclear how the House has been injured by these payments (a concrete injury being a prerequisite for any lawsuit in federal courts), but, more important, the claim can more appropriately be handled by Congress. The courts have no particular facility with the arcana of the appropriations process and have less authority and ability to remedy the alleged problem than Congress does.
The Cadillac Tax: Loved by Economists, and Few Others
The so-called Cadillac tax is one of those rare taxes whose primary purpose is not to raise revenue. The tax, which is scheduled to begin hitting very-high-cost employer-sponsored health insurance plans in 2018, was included in the Affordable Care Act to discourage companies from offering such plans.
As economists say, “Tax something and get less of it.” This is appealing to those who would like to control health care spending, which ultra-comprehensive health plans tend to encourage more of. But it’s not very appealing to people who have the plans, many of them members of unions that fought hard to get the plans in the first place.
A lot of the news coverage last week, after Hillary Rodham Clinton announced she’d like to see the tax repealed, focused on the fact that repealing the tax could cause the federal government to lose $87 billion in revenue over the first eight years it’s in effect. Mrs. Clinton has said any repeal should be offset with other measures to close that gap.
But the revenue effects of the Cadillac tax are minor compared with the tax’s much larger effects on health care spending. It would be harder for Mrs. Clinton to replicate those cost-control benefits than to replicate the revenues.
The tax is expected to cut health care costs in two ways. First, it would encourage employers to give their employees less generous health benefits and instead pay them more in cash. Second, a reduction in free-spending health plans would reduce the overall demand for health care services, making it harder for doctors and hospitals to raise prices. As a result, the tax is expected to reduce the cost of care even for people whose health plans do not change because of the tax.
The tax would push against another public policy that encourages people to spend more on health care than they otherwise might: the longstanding exemption of employee health benefits from both income and payroll taxes. Tax exemptions for health spending cost the federal government $300 billion a year, nearly as much as the federal government spends on Medicaid. The Cadillac tax would effectively shrink those income and payroll tax breaks, but only to the extent that a health plan’s premium exceeds a high price cap, about 50 percent higher than the cost of the average plan.
Want to see what Alabama insurance executives make? New law says that's now secret
By Amy Yurkanin
The Birmingham News (AL.com), Sept. 28, 2015
If you want to know what the CEO of your health insurance company earned last year, don't ask the Alabama Department of Insurance.
That information is no longer public – because of a new law that shields much of the information used to review the state's insurance providers. The law reverses an open-book policy that had been in place for years.
Officials with the Alabama Department of Insurance sought the change during the regular legislative session – in an effort to comply with the requirements of an organization that accredits insurance regulators, said Chief of Staff Mark Fowler. The bill initially made work papers confidential, but included salaries after conversations with members of the insurance industry.
"That came from industry feedback," Fowler said. "When we offered the bill up, we agreed to go along with it. We felt like there was no real regulatory aspect of that. It didn't contribute to regulating those companies."
The bill, sponsored by state Sen. Slade Blackwell (R-Mountain Brook), enjoyed near-unanimous support in the legislature and received the governor's signature in May.
But some health insurance attorneys are concerned about the implications of the new law. In previous years, citizens had access to more information about how insurance companies spent their money. So if a member believed a rate increase was unreasonable, he could look at the documents and file a lawsuit based on that information, said Jim McFerrin, a health care attorney.
"Basically what it does is create a web of transparency so anyone who is interested can go in and take a look see at the numbers," McFerrin said.
It will be much more difficult to determine how insurance companies are spending money in the future, and more difficult to challenge rate increases, McFerrin said.
"A decrease in transparency means a decrease in accountability," McFerrin said.
The law will benefit some companies more than others. National health insurance companies such as UnitedHealthcare and Aetna report compensation and other information in annual reports to the Securities and Exchange Commission.
Blue Cross Blue Shield of Alabama, which dominates the health insurance market in Alabama, does not report to the SEC, and is not required by the IRS to file a form that shows executive compensation.
"We kind of felt like this ought to be confidential as well since it had to do with personal information."
"We are not a charitable nonprofit required to file a Form 990, and we do not release our employees' compensation information," wrote Blue Cross spokeswoman Koko Mackin in an email.
The company's high executive pay and generous bonuses have raised questions in the past. The top ten executives at Blue Cross Blue Shield of Alabama earned more than $1 million each in 2013, according to Al.com. President and CEO Terry Kellogg earned a total of $4.84 million that year. The top executives at the company collectively doubled their compensation between 2011 and 2013.
"If they can pay the salaries in secret, God knows how much they're going to pay now," said Joe Whatley, an attorney who is leading a class action lawsuit against Blue Cross Blue Shield.
http://www.pnhp.org/print/news/2015/september/want-to-see-what-alabama-insurance-executives-make-new-law-says-thats-now-secret
The Birmingham News (AL.com), Sept. 28, 2015
If you want to know what the CEO of your health insurance company earned last year, don't ask the Alabama Department of Insurance.
That information is no longer public – because of a new law that shields much of the information used to review the state's insurance providers. The law reverses an open-book policy that had been in place for years.
Officials with the Alabama Department of Insurance sought the change during the regular legislative session – in an effort to comply with the requirements of an organization that accredits insurance regulators, said Chief of Staff Mark Fowler. The bill initially made work papers confidential, but included salaries after conversations with members of the insurance industry.
"That came from industry feedback," Fowler said. "When we offered the bill up, we agreed to go along with it. We felt like there was no real regulatory aspect of that. It didn't contribute to regulating those companies."
The bill, sponsored by state Sen. Slade Blackwell (R-Mountain Brook), enjoyed near-unanimous support in the legislature and received the governor's signature in May.
But some health insurance attorneys are concerned about the implications of the new law. In previous years, citizens had access to more information about how insurance companies spent their money. So if a member believed a rate increase was unreasonable, he could look at the documents and file a lawsuit based on that information, said Jim McFerrin, a health care attorney.
"Basically what it does is create a web of transparency so anyone who is interested can go in and take a look see at the numbers," McFerrin said.
It will be much more difficult to determine how insurance companies are spending money in the future, and more difficult to challenge rate increases, McFerrin said.
"A decrease in transparency means a decrease in accountability," McFerrin said.
The law will benefit some companies more than others. National health insurance companies such as UnitedHealthcare and Aetna report compensation and other information in annual reports to the Securities and Exchange Commission.
Blue Cross Blue Shield of Alabama, which dominates the health insurance market in Alabama, does not report to the SEC, and is not required by the IRS to file a form that shows executive compensation.
"We kind of felt like this ought to be confidential as well since it had to do with personal information."
"We are not a charitable nonprofit required to file a Form 990, and we do not release our employees' compensation information," wrote Blue Cross spokeswoman Koko Mackin in an email.
The company's high executive pay and generous bonuses have raised questions in the past. The top ten executives at Blue Cross Blue Shield of Alabama earned more than $1 million each in 2013, according to Al.com. President and CEO Terry Kellogg earned a total of $4.84 million that year. The top executives at the company collectively doubled their compensation between 2011 and 2013.
"If they can pay the salaries in secret, God knows how much they're going to pay now," said Joe Whatley, an attorney who is leading a class action lawsuit against Blue Cross Blue Shield.
http://www.pnhp.org/print/news/2015/september/want-to-see-what-alabama-insurance-executives-make-new-law-says-thats-now-secret
Congress and Obama Administration Seek Ways to Limit Increase in Medicare Premiums
By ROBERT PEAR
WASHINGTON — Congress and the Obama administration are frantically seeking ways to hold down Medicare premiums that could rise by roughly 50 percent for some beneficiaries next year, according to lawmakers and Medicareofficials.
The administration has criticized commercial insurance companies for seeking rate increases much smaller than that.
Aides to Representative Nancy Pelosi of California, the House Democratic leader, and Speaker John A. Boehner are quietly exploring a possible deal that would limit the expected increase in Medicare premiums.
“Congress has a responsibility to act,” Ms. Pelosi said by email on Monday. “If we do nothing, millions of American seniors will suffer. Democrats continue to press the Republican leadership to bring a fix to the floor so we can prevent the serious harm this increase will have.”
The cost of avoiding such big premium increases, $7.5 billion by some estimates, could be a problem for conservative Republicans. Aides to Mr. Boehner have told Ms. Pelosi’s staff members that the cost would have to be offset by savings elsewhere in the federal budget.
White House officials have discussed the issue with congressional aides, but said they were also considering administrative action to moderate the increase in premiums, perhaps by using a Medicare contingency fund. It is unclear how much they might do on their own.
“We share the goal of keeping Medicare’s premiums affordable, are exploring all options, and appreciate the interest and ideas of members of Congress,” said Katie Hill, a White House spokeswoman.
Premium increases could affect about 30 percent of the 51 million people enrolled in Part B of Medicare, which covers doctors’ services, outpatient hospital services, some home health care and other items. Spending for these services grew slightly more than expected last year, officials said.
Republicans worry that Democrats will depict them as waging a “war on seniors” if they do not go along with legislation to soften the effect of any premium increase, perhaps by using general revenue to plug the gap. A struggle over Medicare would add to fights expected this fall over legislation to raise the federal debt ceiling, prevent a government shutdown and keep money flowing for highway projects.
Medicare officials are scheduled to announce the 2016 premiums this month, after the federal Bureau of Labor Statistics releases data on consumer prices. Medicare’s annual open enrollment period, during which people can change their coverage, begins on Oct. 15.
Under federal law, Medicare premiums are linked closely to Social Securitybenefits. Inflation has been so low that Social Security beneficiaries may not receive a cost-of-living adjustment next year, federal officials said. For most Medicare beneficiaries, that means that their premiums will stay the same.
Gov. Brown signs controversial assisted-suicide bill
Caught between conflicting moral arguments, Gov. Jerry Brown, a former Jesuit seminary student, signed a measure Monday allowing physicians to prescribe lethal doses of drugs to terminally ill patients who want to hasten their deaths.
Brown appeared to struggle in deciding whether to approve the bill, whose opponents included the Catholic Church.
“In the end, I was left to reflect on what I would want in the face of my own death,” Brown wrote in a signing message. “I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill. And I wouldn’t deny that right to others.”
The new law is modeled after one that went into effect in 1997 in Oregon, where last year 105 people took their lives with drugs prescribed for that purpose.
The California law will permit physicians to provide lethal prescriptions to mentally competent adults who have been diagnosed with a terminal illness and face the expectation that they will die within six months.
The law will take effect 90 days after the Legislature adjourns its special session on healthcare, which may not be until next year — January at the earliest, November at the latest.
The governor's action caps months of emotional and contentious debate over the End of Life Option Act, which divided physicians, ethicists, religious leaders and the Democratic majority in the Legislature.
Tim Rosales, a spokesman for Californians Against Assisted Suicide, which includes doctors, advocates for the disabled, the California Catholic Conference and other religious groups, criticized Brown’s action.
“This is a dark day for California and for the Brown legacy,” Rosales said. “As someone of wealth and access to the world’s best medical care and doctors, the governor's background is very different than that of millions of Californians living in healthcare poverty without that same access — these are the people and families potentially hurt by giving doctors the power to prescribe lethal overdoses to patients.”
Catholic Church officials, when asked for comment, said Rosales would speak for them. Rosales said the coalition is considering its options, including a lawsuit and a referendum.
EMMC touts $305 million renovation
By Evan Belanger, BDN Staff
Posted Oct. 05, 2015, at 6:46 p.m.
BANGOR, Maine — Eastern Maine Medical Center is on track to spend $305 million on a multiyear project to expand and modernize its State Street campus.
After more than two years of construction, the first phase of the project is slated for completion by the end of March 2016.
About six months from completion, hospital officials on Monday granted media tours of the eight-story, 350,000-square-foot addition, which the hospital broke ground on in September 2013.
Facilities slated to be operational in March include a new entrance, lobby, gift shop and dining area as well as a 32-bed cardiac telemetry unit and a 29-bed neonatal intensive care unit.
According to Jay Hagerty, a neonatologist with the hospital, EMMC delivers about 2,000 babies annually and provides care for another 1,800 to 2,000 newborns transferred from other hospitals.
“There’s more space per baby,” he said. “Every baby has their own … private room that allows us to do light, temperature, sound [and] humidity all based on that individual patient’s needs,” he said.
Second-phase projects will consolidate the hospital’s cardiac services, add 14 new operating rooms, a new post-anesthesia recovery room and a renovated labor and delivery unit.
Those projects, which are under way, are scheduled to be completed throughout 2016 and 2017 with the last items being completed by the summer of 2017.
According to Helen McKinnon, a registered nurse and vice president of the hospital’s support services, patient and doctor input played a heavy role in designing the expansion.
“We’ve been planning it for 10 years,” she said. “We’ve been getting input from a lot of referral hospitals, physicians and our patients for a long time.”
Each new patient room will be private and will feature expanded amenities for family members. The renovation also will replace the hospital’s 40-year-old kitchen that serves more than 1,000 meals per day.
The expansion will increase the hospital actual bed count from about 300 to 411, the maximum allowed by its certificate of need with the state.
Patients will likely notice that in the form of shorter wait times at the emergency room, McKinnon said.
“With the additional beds, we’ll be able to pull any patients that need admissions much more quickly,” she said.
Hospital officials estimated the total cost of the project, including about $40 million to replace medical equipment, at about $305 million.
That’s up from the $287 million hospital officials estimated at the start of the project more than two years ago.
Money for the project comes from a combination of bonds, MaineCare settlement funds paid by the state, operating cash and equity and private contributions.
Monday’s tours come after the hospital announced in March 2014 that it was facing a $7 million shortfall because of reduced government reimbursements, fewer patients than expected and an increase in unpaid care.
McKinnon said Monday that the hospital actually closed its latest fiscal year with a slim operating margin to the positive, and Senior Vice President and Chief Financial Officer Lawrence McManus said the hospital is projecting a 5.4 percent operating margin for fiscal 2015, which began Oct. 1.
Asked whether the cost of the project would be reflected in health care costs, Lawrence said in a statement that the cost was considered in terms of quality patient care, the provision of complex medical services in the region and cost of future capital improvements. He did not indicate whether it would result in increased hospital bills for patients.
Commentary: Health care can’t help but suffer when the human touch is lost
by Richard K. Jennings
BRUNSWICK — Being a physician, and in my 88th year, I can appreciate Dr. Atul Gawande’s book “Being Mortal: Medicine and What Matters in the End” for many reasons, but I think end-of-life issues predominate. Therefore, my thoughts are multiple and difficult to contain. (Additionally there is Barney Frank’s column in the Aug. 9 Maine Sunday Telegram, “End-of-life politics ooze absurdity,” revealing how much could be saved through truly compassionate care at this most critical time.)
In “Being Mortal,” Dr. Gawande eloquently describes the current “treatment” of the elderly sick and disabled in nursing homes and assisted living residences, as well as the lack of human interaction involved, all in the name of caring.
In contrast, in my early practice as a general practitioner some 60 years ago, with $3 office visits and $5 house calls, doctors were on call 24 hours a day, went to homes and routinely knew their patients on a personal basis – a situation rarely if ever true now.
Over several decades, technology – computers, automated record-keeping, highly refined tools such as CAT scans and the MRI – has transformed the practice of medicine. In addition, doctors have become “employees” of the insurance industry and are no longer individual practitioners. They are insulated from meaningful patient contact by multiple staff, sterile exam rooms, large office buildings and multiple layers of paper.
Of even greater import, though, is the isolation of those nearing the end of life, whether in nursing homes or a similar setting with a more catchy name. Dr. Gawande illustrates these problems with several emotionally charged case histories.
As a physician I can clearly see how we have moved from caring for and about the person whom we face to treating a condition that challenges us. To be sure, “do no harm” is still a basic ethical principle, but the understanding of “harm” may have changed, and “harm” may have taken on a much broader meaning in the context of hugely advanced technology.
Need a real discussion on humane, cost-effective health care system
By William M. Fogarty Jr., M.D.
St. Louis Post-Dispatch, Letters, Oct. 6, 2015
In his article ("Again? Health Care Debate Expands for 2016," online Oct. 2) Ricardo Alonso-Zaldivar outlines the three approaches that the various candidates for the presidential nomination offer on health care. They range from the single-payer approach espoused by Bernie Sanders, through the middle ground basically supporting the status quo offered by Hillary Clinton, to the "repeal and replace" position of the Republican contenders. Unfortunately, the Republicans offer no details of their replacement and also attack Medicare and Medicaid, which serve some 100 million Americans, without offering a viable alternative.
The writer states that the single-payer option would call for "a massive tax increase" not allowing for the fact that that increase would be more than offset by replacing the premiums now paid to insurance companies and the $400 billion that would be saved in administrative costs and insurance company profits, not to mention the savings in drug and device costs that would result from competitive purchasing.
Hopefully, we will move beyond the circus we are now enduring in the Republican primary run-up to a real discussion of the issues important to this country. Among those is how we are going to craft a humane, cost-effective, high-quality heath care system that serves everyone. Among the options being discussed, the single-payer system is the only one with the potential to fulfill that goal.
Dr. William M. Fogarty Jr. resides in Webster Groves.
http://www.pnhp.org/print/news/2015/october/need-a-real-discussion-on-humane-cost-effective-health-care-system
St. Louis Post-Dispatch, Letters, Oct. 6, 2015
In his article ("Again? Health Care Debate Expands for 2016," online Oct. 2) Ricardo Alonso-Zaldivar outlines the three approaches that the various candidates for the presidential nomination offer on health care. They range from the single-payer approach espoused by Bernie Sanders, through the middle ground basically supporting the status quo offered by Hillary Clinton, to the "repeal and replace" position of the Republican contenders. Unfortunately, the Republicans offer no details of their replacement and also attack Medicare and Medicaid, which serve some 100 million Americans, without offering a viable alternative.
The writer states that the single-payer option would call for "a massive tax increase" not allowing for the fact that that increase would be more than offset by replacing the premiums now paid to insurance companies and the $400 billion that would be saved in administrative costs and insurance company profits, not to mention the savings in drug and device costs that would result from competitive purchasing.
Hopefully, we will move beyond the circus we are now enduring in the Republican primary run-up to a real discussion of the issues important to this country. Among those is how we are going to craft a humane, cost-effective, high-quality heath care system that serves everyone. Among the options being discussed, the single-payer system is the only one with the potential to fulfill that goal.
Dr. William M. Fogarty Jr. resides in Webster Groves.
http://www.pnhp.org/print/news/2015/october/need-a-real-discussion-on-humane-cost-effective-health-care-system
Can Mass. do health care better, cheaper, and more efficiently?
Massachusetts is considered a national leader for expanding health insurance coverage to nearly all of its residents. But can it be a leader in changing the way health care is delivered so that it costs less and is better for patients?
During a week of big questions, this may be one of the biggest. Governor Charlie Baker and health care leaders from Boston and beyond will tackle it Wednesday at Massachusetts General Hospital during an all-day symposium that is part of HUBweek, the art, science and technology festival sponsored by Mass. General, The Boston Globe, Harvard University, and MIT.
“Massachusetts was a leader in insurance reform,” said Dr. Timothy G. Ferris, senior vice president of population health management at Partners HealthCare, Mass. General’s parent company, and an organizer of the forum. “But the end goal is to get more efficient, better care to the population, and ultimately better health. The question of the symposium is: Is this playing out in Massachusetts?”
The discussion comes as hospitals and insurers are under growing pressure to control the costs of medical care while also improving the quality. In Massachusetts, the state has set a benchmark to hold the annual increase in health care spending at or below 3.6 percent; last year, spending climbed 4.8 percent, due largely to higher costs of Medicaid, the government program that insures low-income residents.
Massachusetts is home to some of the nation’s best hospitals, but also has among the highest health care costs in the country. To control costs and improve care, many health care organizations are employing new strategies, such as using care managers to coordinate the treatment of patients with chronic disease, or using fitness trackers to monitor how much patients exercise.
Ferris said health care providers have a lot of room for improvement. Patients want to e-mail their doctors, schedule appointments online, and find information on the costs of medical services, he said — all things that seem simple, but are not yet commonplace in the industry.
Kate Walsh, chief executive of Boston Medical Center, said the challenge before health care leaders is to bring costs down, but without slowing innovations in drugs, treatments, and medical devices that play a big role in the Greater Boston economy.
“If you think about it, in most industries when you apply technologies, cost comes down,” Walsh said. “It doesn’t seem to happen in health care, so what can we learn from other industries so we can manage costs?”
Walsh and three colleagues — Andrew Dreyfus, chief executive of Blue Cross Blue Shield of Massachusetts; Dr. Peter L. Slavin, president of Mass. General; and Daniel Tsai, assistant secretary of the state’s Medicaid program — will address this thorny question at the forum.
“Managing costs, that’s something I think we continue to work on,” Walsh said. “As an industry, everyone’s committed.”
The Wednesday forum will include discussions about preventive care, chronic care, and the idea of patients as consumers. Baker, the former chief executive of Harvard Pilgrim Health Care and state secretary of Health and Human Services under former governor William Weld, will be the keynote speaker.
No comments:
Post a Comment