Governor Maura Healey came to Cape Cod Hospital in Hyannis on Monday, Aug. 3, to promote the work of the Health Care Affordability Working Group she created earlier this year.
The group’s goal is to make recommendations for actions that will lower health care costs across Massachusetts.
The group’s first 12 recommendations target out-of-network charges, prescription drug prices, workforce shortages, and what the administration calls “preventable hospitalizations.”
Before speaking to the media, Gov. Healey donated blood at the Nicholas G. Xiarhos Blood Donor Center at the hospital. Xiarhos, a Yarmouth native, was killed in action while serving with the Marines in Afghanistan.
Healey said that in response to a Working Group recommendation she will issue an executive order directing MassHealth to increase spending in primary care to 12 percent of total medical spending by the end of 2028. This includes reforming the payment structure to support coordinated team-based care, and making it easier to recruit and retain providers.
“That’s a meaningful investment that’s going to make a difference; it’s going to mean more primary care for people in Massachusetts,” Healey said. Her administration will also attempt to more fully integrate behavioral health into primary care.
The Working Group is also calling for reducing fees charged by out-of-network providers, leading to surprise bills to patients.
Healey said a too-common scenario is that someone becomes ill while away from home and seeks medical treatment, only to find out later that one of the providers was not in their healthcare network and the fee is far more than the patient expected.
“We’re going to prevent that from happening,” Healey said, “Because nobody should be surprised by getting a big bill for unknowingly getting treated by an out-of-network provider.”
Healey said she will direct the state’s Division of Insurance to establish default out-of-network payment rates. This will involve negotiations with insurers and providers.
Cape Cod Healthcare CEO Michael Lauf welcomed Healey’s attempts to reduce healthcare costs.
“It’s not lost on us that we are a not-for-profit community- based and -owned health system. We employ 5,00 people, or 10 percent of the Cape’s GDP. Hundreds of thousands of ER visits every year, and 1.2 million outpatient visits. Twenty-one thousand surgeries, 18,000admissions, number one employer and we’re still not affordable,” Lauf said.
Lauf said he talked with Healey about Cape Cod Healthcare’s efforts to reduce costs, such as a comprehensive stroke care system that allowed 5,000 people to be treated near home last year. CCHC also has a Level 3 trauma designation that kept about 500 people from having to go to Boston hospitals for treatment last year.
Lauf also touted CCHC’s comprehensive cancer treatment which allows patients to be treated closer to home.
“That’s what we are, that’s who we are and that’s what we are going to be,” Lauf said.
He noted that CCHC is also pragmatic and wants to be the state’s partner in finding ways to reduce health care costs for patients.
In a statement, Healey said Massachusetts nursing programs, “turn away qualified applicants every year because they lack enough faculty and classroom capacity.”She said investing in nursing faculty recruitment and retention at community colleges and private institutions will allow schools to train more nurses.
While the first round of recommendations from the Working Group attempts to address serious concerns in the healthcare system, Healey stressed that the group’s work is not done and that additional recommendations can be expected.
