Cooperating for better care.

Massachusetts Hospital Association

Tag Archives

Mass. panel looks at big hospital service-price disparities


A Massachusetts committee has discussed ways of resolving the huge disparity in reimbursement payments to hospitals for the same medical services.

The debate centered around a possible state ballot initiative  to cap insurers from reimbursing providers greater than 20 percent of the average cost for a service, and make them  pay no less than 10 percent below the average price to a provider.

The ballot measure has largely been seen as a scare tactic designed to spur healthcare officials into reformative action. As the ballot deadline creeps closer, however, industry experts are determined to find an alternative.

Some hospital industry leaders shared their thoughts.

Norwood (Mass.) Hospital President Kim Basset said the highest-priced hospitals are routinely reimbursed two-and-a-half to three times higher than hospitals with the lowest prices for the same services. “Immediate action is needed,” Ms. Basset said. “If certain hospitals are allowed to be paid more than others, they will continue to use these proceeds to create an unfair market advantage against community hospitals.”

Tim Genz, executive vice president of Massachusetts Hospital Association, focused on  increased price transparency to push consumers to use lower-priced providers.

Steve Walsh, executive director of the Massachusetts Council of Community Hospitals, said, “[We used] a blunt instrument to start a conversation that needs to be started, but… this is the right church, wrong pew.”




A Web site to simplify healthcare administration?!


Fierce Healthcare reports that the Mass Collaborative,  with more than 35 health plans, healthcare providers and trade associations, has developed a new Web site to standardize and simplify healthcare administration processes and costs.

Massachusetts is a rich and high-tech state. The question is whether such sites can be created in less sophisticated places. And economic, political and social constituencies will continue to militate against simplification, as they do in Congress and state legislatures.

Much of American healthcare’s sky-high cost can be attributed to the fact  that hospitals and other providers (who are the highest paid in the world) must negotiate multiple contracts with insurers. The cliche is the Western Europeans are the most bureaucratic and rep-tape-bound nations, when, in fact, from America’s healthcare ”system” to our multi-jurisdictional regulatory ”system” to our incomprehensible tax ”system,” America is much worse.

Fierce Healthcare reports that the aforementioned Web site ”features standardized industry forms and strategies to address insurance eligibility verification and claim appeals. Its goal is to take the cost and complexity out of the system and improve the overall end-to-end experience for healthcare providers, payers and patients in the state, according to Lynn Nicholas, president and CEO of the Massachusetts Hospital Association.”

It’s hard to believe that this will “take the cost and complexity” out of the system, but let’s grant Ms. Nichols poetic license.


Contact Info

(617) 230-4965

Wellesley, Mass