Hospitals and insurers tangle over rising health care costs – WBUR News

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Leaders of the state’s greatest hospital programs and insurers jousted Wednesday about handle the rising prices of well being care at a time when historic staffing shortages are threatening folks’s entry to care.
Dr. Anne Klibanski, the chief govt of Mass Basic Brigham, advised the Massachusetts Well being Coverage Fee that hospitals are inundated with sick sufferers, and severely brief on employees to look after them.
“We are literally at a breaking level, and affected person care is on the danger of being compromised,” she stated. “And I by no means thought I might say that, however that truly is the place we’re.”
Klibanski stated the present disaster is worse than the early days of the COVID pandemic as a result of it has continued for therefore lengthy and isn’t enhancing.
She was amongst a number of well being care leaders known as to testify in entrance of the Well being Coverage Fee on Wednesday, in a dialogue that uncovered the rigidity between well being care suppliers experiencing a number of pressures and policymakers in search of to make well being care extra inexpensive for sufferers.
The fee set a statewide goal for holding the expansion of well being spending to three.6% a 12 months. Hospitals or insurers who exceed that focus on might be compelled to undertake a cost-cutting plan.
“We are literally at a breaking level, and affected person care is on the danger of being compromised. And I by no means thought I might say that, however that truly is the place we’re.”
Mass Basic Brigham, the state’s greatest and most costly hospital system, is the one group thus far that has been required to observe such a plan due to its excessive spending. It has promised to slash spending by $127.8 million yearly, partially by decreasing costs.
Leaders of the Well being Coverage Fee have argued they want extra authority to carry the well being care trade accountable for spending.
However Klibanski stated hospitals are grappling with larger prices pushed by inflation — and lots of are dropping cash. She stated they shouldn’t be penalized for bills they will’t management.
“I actually fear about what the benchmark means on this notably fragile time. We have executed lots to make well being care extra inexpensive,” Klibanski stated. “However it is a very harmful time for taking good care of sufferers.”
Andrew Dreyfus, chief govt of the state’s greatest well being insurer, Blue Cross Blue Protect of Massachusetts, pushed again. He stated he understands hospitals are dealing with pressures, however worries about constructing extra value into insurance coverage premiums, that are already rising.
“We even have to consider, what are we going to do about affordability?” he stated. “As a result of I see a form of looming disaster in Massachusetts.
“On the one hand, we’ve hospitals which are below monumental stress and strain,” he stated. “However, we’ve an inflationary setting and a probably looming recession. We have now companies, particularly small employers, who cannot bear the rising prices of well being care.”
Knowledge from the fee present that costs for hospital providers and pharmaceuticals have been rising for years, and the well being care trade has turn into extra consolidated.
These developments have an effect on the prices that customers and companies pay. Annual household medical health insurance premiums, not together with out-of-pocket prices, averaged $22,163 in Massachusetts final 12 months, the fee stated. And many individuals are skipping medical care due to the fee.
Dr. Eric Dickson, chief govt of UMass Memorial Well being, stated three elements are driving up spending: administrative waste, drug costs and labor prices.
“If we do not handle these root causes, we is not going to do something to the price of well being care on this nation or within the state,” Dickson advised the fee.
Dr. Kevin Churchwell, chief govt of Boston Kids’s Hospital, stated his establishment is struggling to accommodate the surging numbers of younger sufferers with psychological well being situations, and the rise in kids with RSV and different respiratory sicknesses.
“The system was not ready for this,” he stated. “The system was not staffed for it.”
Churchwell stated the state must work with well being care suppliers to handle the disaster.
“How can we stroll, chew gum, throw a soccer, all on the identical time? And the way can the state assist us try this? These are actually complicated points,” he stated.
Gov. Charlie Baker additionally addressed the fee and stated the basics of the well being care fee system want to alter. Baker known as for extra funding in main care and behavioral well being to assist folks keep wholesome and keep away from expensive procedures and hospital stays.
Baker twice proposed sweeping laws to shift well being care {dollars} by spending 30% extra on main care and behavioral well being — however his plan foundered within the Legislature.
“Many of the cash we spend is after folks get sick,” Baker advised reporters. “And we aren’t doing, for my part, wherever close to sufficient to maintain them wholesome within the first place.”
Priyanka Dayal McCluskey Twitter Senior Well being Reporter
Priyanka Dayal McCluskey is a senior well being reporter for WBUR.
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Originally posted 2022-12-02 23:06:17.

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