By: David Ostrowsky

A year later … and how (relatively) little has changed in the state of Massachusetts healthcare.

Last November, the Massachusetts Association of Health Plans (MAHP) Annual Conference focused on healthcare challenges and opportunities – both from a regional and national perspective -- amidst a receding pandemic. The 2022 conference, headlined by then-Governor Charlie Baker, homed in on two topics: a.) healthcare equity and b.) regulation of provider prices. Twelve months later, on November 17, 2023, the MAHP 2023 Annual Conference, held once again at the Seaport Hotel in downtown Boston, had an eerily familiar theme: “Health Care Affordability, Quality and Equity in a Post Pandemic World.”

Compared to last fall, COVID may be further and further in our rearview mirror but the underlying systemic issues of a largely broken American healthcare system remain just as prominent. This year’s keynote speaker, Marty Makary, MD, MPH, Chief, Islet Transplant Surgery & Professor of Surgery, Johns Hopkins Medicine, (also New York Times bestselling author of The Price We Pay), expressed particular concern about overtreatment and excessive health care spending. The two driving forces behind the runaway costs, from Makary’s viewpoint, are pricing failures in the marketplace, (a primary culprit is negligible transparency on costs of care and services) and pervasiveness of low-value care. There is no one overarching solution for remedying the country’s (and Masschusetts’) health care system, but addressing these two matters, while safeguarding the welfare of society’s most vulnerable, is essential at this hour.

Preceding Dr. Makary’s talk were remarks by Lieutenant Governor Kim Driscoll, who presented at the conference for the second consecutive year. In reflecting on her first year in office in Governor Maura Healey’s administration while previewing Massachusetts healthcare developments in the new year, Driscoll also articulated the message that there still needs to be greater healthcare equity and accessibility for all of the state’s nearly seven million residents. To this end, Lieutenant Governor Driscoll stressed the significance of diversifying the health care workforce and generating a pipeline in underserved communities for providing robust, culturally competent health care.

Reining in healthcare costs also was the dominant theme of the presentation delivered by Mark Miller, Executive VP of Health Care at Arnold Ventures. Miller, who has decades of experience implementing health policy as the Executive Director of Medicare Payment Advisory Commission and Assistant Director of Health and Human Resources at the Congressional Budget Office among other positions, emphasized the importance of transparency in rising pharmaceutical costs, including transparency among patient advocacy groups, as part of the campaign to bolster Rx affordability and accessibility for patients, employers, and taxpayers in general. In the same vein, Kate Walsh, Secretary of Health and Human Services, Commonwealth of Massachusetts -- in conversation with Mallika Marshall, MD, Medical Reporter, WBZ 4, CBS News Boston – made note of MassHealth’s success in direct negotiations with drug manufacturers, which have resulted in some $400 million in prescription drug savings.

The conference concluded with a high-powered panel (Massachusetts Health Policy Commission Chair Deborah Devaux; Paul Hattis, MD, Senior Fellow at the Lown Institute; Jon Hurst, President, Retailers Association of Massachusetts; and Greg Wilmot, President and CEO, East Boston Neighborhood Health Center) discussing the topic du jour -- health care equity and affordability in a post-COVID society. The consensus among the esteemed panelists was that to effectively champion affordability and equity it is paramount to retain a strong cost growth benchmark, require site-neutral payments, bolster the performance improvement process, and include pharmaceutical manufacturers in the Health Policy Commission’s oversight.

Next year’s MAHP Annual Conference will be held on Friday, November 15. Undoubtedly there will be a fresh panel of nationally recognized speakers discussing real-world solutions to pressing challenges in the health care sector. It will be interesting to see, however, if those challenges differ, if at all, from those of the past couple years.