New report from Attorney General sheds light on main health care cost driver in Massachusetts

Just last Friday, Massachusetts Attorney General Martha Coakley released a report pinpointing the main driver of the Commonwealth’s rapidly spiraling health care costs—the market clout of highest paid providers. Simply stated, Massachusetts insurance companies are paying certain doctors and hospitals significantly more than others for the same patient care.

Coakley’s year-long investigation leading up to this report revealed that a small group of roughly 10 hospitals statewide commanded anywhere from 10 to 100 percent higher payments than their competitors for similar work.

The study also found no evidence that this higher pay was due to better quality of patient care or treatment of more complex cases. In fact, the study revealed that:

• Eight in 10 of the best paid hospitals in one insurer’s network were community hospitals. These hospitals tend to have less complex cases than teaching hospitals and also do not have the added cost of training future doctors.
• One major teaching hospital that treats some of the Commonwealth’s sickest patients is paid significantly less than dozens of other hospitals that treat healthier patients.

Coakley’s team did discover that the hospitals commanding higher payments were able to do so because of market leverage from factors such as brand-name recognition and geographic isolation.

What the investigation has done:

At the end of the day, Coakley’s investigation had one major accomplishment. It shed light on the true cause of Massachusetts’ health care cost increases.  Over the past several years, it was revealed that provider rate increases, not higher patient utilization rates, were the main contributors to higher health care costs.

The Attorney General’s office will release the above as well as other related findings in a series of reports over the next several weeks.  From March 16 through the 31^st, hearings will be held on the issue and state officials will ask hospitals, physicians, insurers, employers and consumer groups to testify on factors contributing to health care cost increases and what could be done to make health care affordable.

As the reports are released and hearings go under way, we’ll make certain to keep you up-to-date on all findings and developments you’ll need to know.