Massachusetts Officials Approve Plans For Free-Care Pool

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Massachusetts officials on Friday said that uninsured residents will not have to pay a $35-per-month deductible before receiving no-cost care at hospitals but that instead they will contribute co-payments for services, the Boston Globe reports (Dembner, Boston Globe, 9/22).

Under proposed rules issued in July, uninsured residents with incomes between150% and 200% of the federal poverty level would have been required to pay the monthly deductible. Those with incomes between 100% and 200% of the poverty level would have been required to contribute a $5 copay for office visits in a hospital and $50 for emergency department visits that did not result in admission. People with incomes between 200% and400% of the poverty level would have paid a larger deductible based on income. There were no proposed copays or deductibles for children or for care received at community health centers, except for a $3 copay per prescription (Kaiser Daily Health Policy Report, 8/24).

Under the compromise plan, to take effect Dec. 1, patients with annual incomes between 101% and 200% of the poverty level will contribute a $5copay for hospital office visits, $50 for inpatient hospital visits and$50 for ED visits that do not result in admission. ED fees will be capped at $250 annually, and there will be no co pays required for children or for care received at community health centers.

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The plan aims to reduce residents' dependency on the state's free-carepool. Health advocates who opposed the deductible rule praised the compromise plan, but they said it still needs some improvements. State officials maintain that they will monitor the new rules and make changes as necessary (Boston Globe, 9/22).

Transparency

In related news, the Massachusetts Health Care Quality and Cost Council on Friday approved a plan to make public the prices insurers reimburse individual hospitals are for certain procedures, the Globe reports. The council plans to spend the next few months determining which treatments and procedures to include in the data and to begin posting information online by March 2008. The council also plans to include some quality measures.

The "unproven" theory is that the disclosure of such information will help reduce health costs by helping consumers choose high-quality, low-cost providers, which will pressure high-cost providers to become more efficient, the Globe reports. However, Thomas Lee, a council member and president of the physician network for Partners Health Care System,said hospitals could use the information to demand more money from insurers based on what was given to a competitor, which could cause insurers to increase costs rather than reduce them (Kowalczyk, Boston Globe, 9/22).

Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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