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Massachusetts healthcare plan in trouble

December 10, 2009 | Mike Daly

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When enacted, MassHealth was touted as the answer to correcting the problem of the uninsured in Massachusetts. Healthcare providers (i.e., hospitals) and insurers were compelled to take cuts in reimbursement upon implementation of the program several years ago.

Today we find that earlier assumptions about cost and utilization were wrong and that enrollee benefits have to be reduced and providers have to take further cuts. Payments to hospitals and physicians for 2009 are deferred until 2010, and 2010 payments until 2011.

According to recent news reports, MassHealth explained that the shortfall is due to increased enrollment, higher utilization of services, and changes in savings estimates that were assumed in the original budget for the program.

The experience in Massachusetts with healthcare reform is frighteningly similar to the battle being waged today in Washington when it comes to healthcare reform.

A recent article points out that states can be useful as laboratories when it comes to new policy. The author points out that “Massachusetts has provided us with an example of a failed experiment in healthcare policy that should be a warning to all Americans as Democrats push to impose something similar on the rest of the nation.”

I suspect the national plan being considered is riddled with faulty and unreal assumptions pertaining to cost and demand on such a program. When it is enacted, it will probably result in providers and enrollees being expected to make further reductions down the road.

Why the haste to adopt something that will require major changes later?

Congress needs to learn from what is going on in Massachusetts.

Massachusetts healthcare reform is in trouble! Let’s not repeat the same mistakes.

Mike Daly blogs regularly at Action for Better Healthcare.

Related Topics:
  • Massachusetts
  • Washington

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