Last month, my colleague Brian Rosman was in a part of Manhattan near a major medical center. Passing a local deli, he couldn’t help but notice a large sign in the window – “Drug Reps: Get Your Party Platters Here!”

A new coalition starts today on a key aspect of health care cost control. Health Care For All is joining forces with consumer advocates, non-profit organizations, insurers, and providers to launch the Massachusetts Prescription Reform Coalition (MPRC). We are taking action against pharmaceutical marketing practices that wastefully inflate prescription drug costs.

Why drugs? Cost control is critical to the financial viability of health reform. Controlling inappropriate drug marketing should be a key item on any list of meaningful cost control measures. Prescription drugs are among the most commonly used forms of health care today. Over 72 percent of American households have someone taking a prescription medication. And drug prices continue to rise. The average price for the most widely used brand-name drugs rose nearly 50 percent from 2000 to 2006 – more than twice the rate of inflation.

Pharmaceutical marketing is an obvious place to start. Drug companies invest $7 billion yearly in marketing to physicians. Read more…

BETH ISRAEL DEACONESS MEDICAL CENTER SAYS IT AIMS TO BE THE FIRST HOSPITAL IN GREATER BOSTON TO END PREVENTABLE MEDICAL ERRORS THAT HURT PATIENTS. C-E-O PAUL LEVY EXPLAINS THE GOAL HE HOPES TO ACHIEVE BY 2012.

You have a right, as a citizen, when you come into a hospital not to be part of a procedure that causes you to spend more time in a hospital or leave disabled to to be killed. Unfortunately, it’s the nature of hospitalization that people are harmed in hospitals and we feel that it is part of our obligation to the community to try to eliminate that harm.

LEVY SAYS BETH ISRAEL DEACONESS WILL PUBLISH RESULTS AS IT GOES AS WELL AS PATIENT SATISFACTION SURVEYS. MOST HOSPITALS IN MASSACHUSETTS HAVE AGREED NOT TO CHARGE PATIENTS OR INSURERS FOR ERRORS. MANY ARE WORKING IN A MORE LIMITED SCOPE THAN BIDMC TO REDUCE RETURN HOSPITALIZATIONS OR HOSPITAL ACQUIRED INFECTIONS. THOSE INFECTIONS ALONE ARE ESTIMATED TO KILL ABOUT 2,000 PATIENTS IN MASSACHUSETTS EVERY YEAR AND LEAD TO MORE THAN 473-MILLION DOLLARS IN UNNECESSARY COSTS.

YOU MIGHT WANT TO BE EXTRA CAREFUL AS YOU SORT THE JUNK AND SAVE MAIL OVER THE NEXT FEW WEEKS. HEALTH INSURERS, AND IN SOME CASES EMPLOYERS, ARE SENDING OUT A NEW TAX FORM THAT WILL WILL SERVE AS PROOF OF COVERAGE UNDER THE REQUIREMENT THAT ALL RESIDENTS HAVE HEALTH INSURANCE. MELISSA CUMMINGS AT THE DEPARTMENT OF REVENUE SAYS TAXPAYERS WILL USE THIS “1099HC” TO COMPLETE THEIR STATE TAX RETURN.

The form 1099 will give the taxpayer the necessary information they need to complete the schedule HC, which is a new tax form required this year from every resident who files taxes.

RESIDENTS WHO HAVE GOVERNMENT SUBSIDIZED HEALTH INSURANCE WILL NOT RECEIVE A 1099HC. FOR MORE INFORMATION ABOUT THIS FORM, TAX PENALTIES FOR FAILURE TO HAVE HEALTH INSURANCE, OR APPLYING FOR A WAIVER CLICK HERE.

When I began my first full legislative session as Speaker of the House of Representatives, I resolved to lead the members of the House toward the design and successful passage of legislation that would protect all of the Commonwealth’s residents from the harms of being uninsured or underinsured. When the health reform law was enacted by the Legislature in 2006, we all resolved to support a three-year implementation for what would be a lifetime of positive change. We knew that the change would be vast – a culture change that wouldn’t come easily or without controversy.

As 2008 begins, we are right where we hoped to be – seeing enormous financial and political investment to bring health insurance to market for hundreds of thousands of people. Chapter 58 was a delicate balance of policies created to improve the lives of our uninsured while protecting the already insured. Now, the final phases of implementation have piled onto the delicate balance new entities like the Connector and the Health Care Quality and Cost Council, new responsibilities for existing agencies like the Department of Revenue, and newly insured residents of all incomes. As the challenges build, so too must our resolve to address them.

Cost containment is the next such challenge. Read more…

The Massachusetts Medical Society asked 2 consultants to evaluate new programs in place that rate physician performance and reward doctors who do better than others. The press release that explains the conclusions is below. Health insurers and employers are doing this, they say, to help patients get the best care and best value for their money. Many us will soon, if we don’t already, have a higher co-payment when we see doctors with less favorable ratings. But are the ratings fair? Here’s the Medical Society’s assessment…

Waltham, Mass. – Jan. 15 – Independent physician consultants have found that several aspects of the Massachusetts health plan methods of rating physicians on cost and quality do not conform to the Massachusetts Medical Society’s (MMS) principles for fair, accurate and clinically relevant physician tiering systems. The consultants, John D. Freedman, M.D., M.B.A., and Bruce E. Landon, M.D., M.B.A., said these findings “raise concerns about the potential for these programs to adversely affect patients and physicians.” Read more…

…than I can on choosing a hospital to go to. While I can turn to consumer guides for purchases of anything but healthcare, patients and purchasers are left in the dark when it comes to important details about the quality of care in hospitals. A case in point is hospital acquired healthcare infections.

Hospital-acquired infections represent a direct threat to patient safety and health care quality. When SEIU 1199 analyzed 2005 discharge data for Massachusetts’s hospitals, we found that nearly 8 out of every 100 inpatients may have acquired an infection while in the hospital. We also found that the mortality rate among inpatients with a possible hospital acquired infection was 8.8%, compared to a mortality rate of 1.6% among inpatients without an infection. In 2005 alone, possible MA hospital acquired infections were associated with an additional 4,619 deaths.

Hospital acquired infections are life threatening, but they are also very costly. Read more…

Contributor David Himmelstein and collegues at Cambridge Health Alliance analyzed 90,000 Emergency Department visits for this study that appears on the Health Affairs website today. They found that the length of time between arrival and the first visit from a doctor increased for all patients between 1997 and 2004. The increase was greatest for severely ill patients.

Nancy Turnbull’s year-end entry was a thought-provoking way to start the new year and as a result, generated some good discussion about health care costs and containment strategies. It is a conversation whose time has come.

The Massachusetts Association of Health Plans (MAHP) released in December a package of legislative proposals and voluntary measures its member health plans will adopt, including public disclosure of health care revenues and expenses, to help consumers and employers understand where the money is going in health care. Also in December, the Commonwealth released its Healthy Massachusetts Compact, a similar plan, which builds upon five elements to achieve its goals of ensuring access to health care; advancing health care quality; containing costs; promoting individual wellness; and promoting healthy communities.

What excites me is that health care reform has created an unprecedented opportunity—and desire—among different but related groups, all of whom have a role to play in keeping health care costs as affordable as possible. This groundswell is moving us all toward a common goal. Read more…

250 physicians in Massachusetts who argue that a national health coverage plan is the only way to make health care work in this country are out with an analysis of the state’s attempt to cover the uninsured. Their assessment uses numbers that are more favorable to that point of view than are the latest numbers from the state. But many people tracking the law share concerns raised in this letter about whether the state and individuals can afford the law.

I recently received phone calls from a few small employers who are members of Associated Industries of Massachusetts (AIM) expressing strong concern about the new “minimum creditable coverage” (MCC) standards which will become effective on January 1, 2009. The provision which is generating the concern is the requirement that insurance must cover prescription drugs in order to fulfill the MCC mandate. Individuals with insurance coverage which does not include prescription drugs presumably will not satisfy the requirements of the individual mandate and will therefore be subject to a penalty as high as $912 in 2008.

Although the new MCC standards are effective on January 1, 2009, in reality, insurance policies are generally in effect for one year, so those renewing on or after February 1st will need to meet the new standards. A recent report released by the Massachusetts Taxpayers Foundation revealed that approximately 163,000 insured individuals do not have prescription drug coverage, 30,000 of whom have non-group coverage and 133,000 of whom have employer-sponsored coverage. These individuals and employers are going to facing very steep premium increases as they renew their coverage in the next 12 months. Not only will they face the 8%-12% “inflationary” increases that most small employers are facing this year, but also their premiums will increase another 15%-20% to reflect the additional cost of a drug benefit.

Although I have to confess that as a board member of the Connector I supported the MCC compromise last March that included prescription drugs, I am now having second thoughts about the wisdom of implementing this requirement as this time. Read more…