Senate President Speech - 2011 Home Care Innovations Showcase and Star Awards

(as prepared) 

Thank you, Jann, and good morning.

I am so pleased to see that several agencies that serve in my district are presenting or being recognized today as innovators.

I want to take a moment to thank the Norwell Visiting Nurse Association, Partners Health Care at Home and Overlook Visiting Nurse and Hospice for their hard work and dedication to their communities and the health care industry.

I know how critical the issues of health care costs, quality, and access are to the residents, businesses and health care providers in this region.

I have heard from constituents who find it increasingly difficult to access timely and appropriate primary care and mental health care services.

I have heard from small businesses in my district that growing health care costs are a major impediment to job creation and economic growth. 

And I have heard from health care providers in my district, who are under extreme financial pressure, that they’ve had to make difficult choices in reducing expenses.

That is why, in my four years as Senate President, I have prioritized action on health care costs and access. 

In 2008, I introduced and passed nation-leading legislation with Senator Richard Moore, with the goal of examining the causes of the growth in health care costs, expanding the use of health information technology, and encouraging new access points for primary care services.

The legislation also streamlines redundant administrative costs and enhances the transparency of financial relationships in the health industry. 

Last year, we passed significant legislation aimed at providing relief to small businesses health care costs by prohibiting inappropriate behavior in the marketplace that drive up costs (ie: jumpers and dumpers), creating standardized measurements for the quality and cost of health care providers, and allowing small businesses to band together to negotiate better health insurance rates.

As the requirements of these new laws continue to be implemented, it is important that we continue to push our efforts forward by focusing on “payment reform”. 

One of my top priorities for the upcoming legislative session is to reform the financial incentives in the current health care marketplace that encourage volume instead of value and hinder the creation of coordinated primary-care networks.  

I believe that Massachusetts can lead the country in payment reform. A careful, phased-in transition away from the current fee-for-service system is achievable with adequate support and monitoring from the state and other payers.

I have suggested a number of guiding principles necessary for this effort to be successful.

First, consumer engagement should be a central element. If consumers feel this is another attempt at intrusive managed care, then it will quickly fail.

Consumers should have a voice in ensuring that the transition to coordinated-care networks, or accountable care organizations (ACOs), does not result in diminished access to necessary services, especially mental health services. Health care quality and access cannot be sacrificed in order to reduce costs. 

Secondly, this effort should seek to empower health care providers to do what they do best: provide high quality, efficient care.

There are committed and creative doctors, nurses, surgeons and administrators across the Commonwealth who are constrained by an outdated system. 

There are strategies and ideas we know that work. They have been proven to save money, like the patient-centered medical home, but unfortunately don’t fit into our current health care payment system.

New payment models should strongly support primary care services and reimburse providers for the 21st century tools necessary to improve quality – tools like electronic medical records, telemedicine and connected health products. 

Specifically, connected health technologies can improve access to primary care and can assist in the management of chronic illness. The remote monitoring of high cost diseases and consumer engagement by physicians and nurses can be greatly expanded through the use of connected health technologies. 

Finally, the reform should avoid unnecessary government bureaucracy. New regulations should be reflective of the wide variety of health care providers in the Commonwealth.

One-size does not fit all. Health care is an important economic engine for our state – and it was one of the only sectors last year to actually grow jobs. 

The private market is already making great strides toward accepting new payment models and reducing costs. Some providers are already participating in global payments, and others will be able to participate soon. 

At the same time, it is important we move forward with a sense of urgency. For businesses to create jobs, for families to earn more, and for government to be able to invest in education and infrastructure – it is an economic imperative to act on health care costs.

Home care providers need to be included in this debate. Home health as an essential part of a coordinated, seamless, patient centered care team and is critical for reducing avoidable hospitalizations and complications.

We know that avoidable emergency department visits and preventable readmissions add over $1 billion in annual health care costs just here in Massachusetts. Coordinated care, including home health, can reduce these costs while also improving quality.

As we move forward with legislation here in Massachusetts, we must also continue to monitor new developments at the federal level.  Significant cuts to Medicare or Medicaid will have a huge impact on Massachusetts. As Washington struggles to find solutions to reducing the deficit, we should all be advocating against short-sighted changes that will weaken Massachusetts and reduce health care access and quality.

Thank you for listening, and thank you for all your hard work.