Mass. Gen. Laws. Ann. ch. 12C, § 16 - Annual report based on information submitted under Secs. 8, 9, and 10; hearing

Annual report based on information submitted under Secs. 8, 9, and 10; hearing

The Center for Health Information and Analysis must publish an annual report based on the information submitted under sections 8, 9 and 10 on health care provider, provider organization and private and public health care payer costs and cost trends.  The Center must compare costs data with the health care cost growth benchmark established by the health policy commission.  The Center must outline:

• Baseline cost, price, quality, utilization, and market power information in the state’s health care system;
• Cost growth trends for care provided within accountable care organizations and patient-centered medical homes;
• Cost growth trends by provider type, including hospitals, hospital systems, non-acute providers, pharmaceuticals, medical devices, and durable medical equipment;
• Factors that contribute to cost growth in the health care system and to the relationship between provider costs and premiums;
• Proportion of health care expenditures reimbursed using fee-for-service versus alternate payment methodologies;
•  Impact of health care delivery and payment system reform on health care costs;
• Impact of assessments on health insurance premiums;
• Trends on the utilization of unnecessary or duplicative services;
• Trends in the adoption of alternative payment methodologies and its impact on overall health care spending, premiums and provider rates;
• The development and status of provider organizations, such as mergers and acquisitions and the development of excessively anti-competitive behavior;
• The impact of health care payment and delivery reform on the quality of care.

The Center’s annual report must report price variation between health care providers, by payer and provider type.  The annual report must include baseline information about price variation among providers by payer type, and must identify providers or provider organizations paid 10% more or less than the average relative price.  The report must also include the annual change in price variation, by payer, factors that contribute to price variation in the state, the impact of price variations on disproportionate share hospitals and other safety net providers,  the impact of health reform efforts on price variation. 

The Center must publish the report at least 30 days before the required annual hearing.  The Center must also provide technical assistance to the health policy commission in compiling its annual report by giving access to data collected under the law.