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August 12, 2008

The latest health care legislation from the People's Republic of Massachusetts

Once again, Massachusetts is out in front on a number of hot issues.  The legislation, championed by Senate President Therese Murray, was signed by Gov. Patrick earlier this week.  See the full text of AN ACT TO PROMOTE COST CONTAINMENT, TRANSPARENCY AND EFFICIENCY IN THE DELIVERY OF QUALITY HEALTH CARE and the Boston Globe story on the new health care law.  The Globe highlights parts of the act that: 

  • Limit pharma industry gifts to providers
  • Provide some funding to get physician offices on EHR systems
  • Require UMass Medical School to graduate more PCPs
  • Institute closer oversight of health insurance premiums

Also of interest are:

  • The mandate for hospitals and community health centers to all be on EHRs by 2015
  • The requirement that facility with EHRs and CPOE be made a condition of physician licensure
  • The HAI and med error reporting requirements, and
  • The reintroduction of DON (that's CON for the rest of the country) jurisdiction
    • for outpatient projects if the capital budget is $25 million or more (ambulatory projects were deregulated years and years ago), and
    • for all ambulatory surgery centers -- not just multispecialty ASCs, and including physician office based ASCs.

A few observations: 

The doom and gloom gang at PhRMA say the gift limits and disclosure requirements will end up marginalizing Massachusetts-based researchers.  Seems unlikely to me.

The $25 million set aside for EHRs is a nice gesture.

More PCPs are key to making the universal health insurance law work -- we have a whole buch of newly-insured folks here in Massachusetts (325,000 or so), and not all of them can access a PCP, because we just don't have enough.

I still have that central health planning gene (thanks to a stint in state government a long while ago), so from the system perspective I am not that put off by the expansion of DON jurisdiction.  I reserve the right to argue differently, of course, in the case of a particular project.

And last of all, let's hope that the HAI and med error reporting system yields some new learning that can help avoid future incidents and errors.

-- David Harlow


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