Mariano takes dim view on chances of health care bill compromise
Photo | Courtesy of Alison Kuznitz, State House News Service
Benson Sloan (right), CEO of Revere Medical, spoke about the future of Steward's physician network during a Health Policy Commission hearing on Thursday.
While experts dissected the state's health care woes exacerbated by the Steward crisis Thursday, House Speaker Ron Mariano took a dim view of the possibility of top Democrats reaching compromise on hospital oversight or prescription drug reform bills approved this session by both the House and Senate.
The Quincy Democrat's comments came just hours after health regulators put the spotlight on the newest private equity investor in Massachusetts and the attorney general again called on lawmakers to give the state stronger enforcement powers.
Mariano had pulled the sprawling health care packages from negotiations during the frenzied end of formal lawmaking of July 31 into Aug. 1, while the Steward Health Care bankruptcy rocked the state's health care landscape. House and Senate Democrats had managed to assemble and pass measures to safeguards patients against similar failures but have been unable to come to an agreement reconciling the bills since.
Asked by a reporter Thursday afternoon if either of those bills -- which the speaker previously indicated were being negotiated together -- are still on his agenda to get done before the two-year legislative session ends in December, Mariano said they were still "a ways away."
"Well, they're still in discussion. We're a ways away, and trying to mesh them and to come to agreement on disparate issues in each bill has been a real challenge," the Quincy Democrat told reporters at the State House after caucusing with House Democrats.
Asked if the bills would be pushed into the next legislative session that starts in January, Mariano said: "Well [if] there's not an agreement reached, we will take a look at streamlining some of this and putting them into separate categories. So yeah."
The House and Senate hospital oversight bills look to boost facility oversight and reporting requirements, increase penalties for failing to report financial data, and overhaul how regulators manage health care costs.
The two health care bills and substance use disorder bills remain locked up in private conference committees. Other major bills that also failed to pass before formal sessions ended Aug. 1 have since emerged with compromises, including a clean energy bill and an economic development bill that advanced to Gov. Maura Healey's desk Thursday.
Down the street from the State House, the Health Policy Commission held its annual costs trends hearing Thursday at Suffolk University School of Law, where state regulators considered solutions to avert another Steward situation. Lead negotiators on the health care bills, Sen. Cindy Friedman and Rep. John Lawn, listened as Attorney General Andrea Campbell pleaded for more rigorous enforcement and accountability powers in her office and for other state agencies.
"We need better tools to stop private equity from stripping the value of our hospitals for a profit," Campbell said. "For example, our health care transparency tools, like these hearings and our office's health care cost trends authority, should extend beyond health care providers and payers to owners and investors in health care, and the failure to report mandated health care data to entities like the HPC and CHIA should be met with steeper penalties if regulators are expected to have a complete picture of the health care landscape."
Campbell argued that her office and the HPC should "have the tools to intervene when transactions will harm our health care system," including transactions involving private equity firms. The attorney general also advocated for updating the False Claims Act, with the aim of holding private equity owners accountability for false claims.
"My team will continue to partner with the Legislature, and I know many are here in this room, and push them to expand our state tools for health care market oversight, which is critical and absolutely necessary in any exercise of accountability," Campbell said. "The AG's office cannot be the only office that does the accountability work. Each of us needs greater tools to also be a part of that work."
Healey mentioned Steward in her remarks to the HPC, though she emphasized that policymakers should also focus on primary care. Healey said she's instructed MassHealth to "look at our buying power and to make sure that we're using that buying power to prioritize investments in primary care."
"We've got to do this," the governor said. "This may likely yield cost savings down the road and will help us rebuild the primary care workforce."
Asked after her remarks if she will file legislation to invest in primary care, the governor said that remains to be seen. She called her instruction to MassHealth "a place to start."
"I also invited the private sector to participate as well, and insurance companies to adopt a similar approach. In terms of legislation, we'll see. I'm not sure yet," Healey told reporters.
As the HPC in recent months vetted the sales of the Steward hospitals and physician network to new operators, regulators lamented they lacked the authority to block or impose conditions on transactions.
In its cost trends report, the HPC recommends expanding the agency's ability to review proposed transactions involving private equity, boosting transparency requirements among providers targeted by private equity investors, and strengthening enforcement actions for providers that do not submit required financial information.
The HPC's frustration over its limited authority was on display Thursday as regulators grilled Benson Sloan, CEO of Revere Medical, about the role of private equity backing his company. Revere Medical is the reimagined Stewardship physician group, which was acquired by Rural Health Group, an affiliate of private equity company Kinderhook Industries.
Commissioners in October voiced skepticism over RHG's non-binding pledges to comply with transparency and market oversight requirements, and to provide periodic updates to the HPC about personnel changes and any "significant financial activities."
Martin Cohen, vice chair of the board, on Thursday pressed Sloan to outline assurances that Revere Medical is "committed to our state's reporting and oversight requirements" and to maintaining access for vulnerable patients, including those who are MassHealth members.
Sloan asked the HPC to give Revere Medical time to build trust in Massachusetts, saying respect will be earned as providers fulfill their promise to increase patient access and improve quality.
"Sure, we are supported by private equity. I view that as a funding mechanism, as there are other funding mechanisms such as not-for-profit funding, public funding, and you can judge all of those three categories for how well they execute, and you can judge us," said Sloan, who later said he wants to create a "sustainable" business.
Barbara Blakeney, chair of the HPC's Care Delivery Transformation Committee, asked Sloan to clarify Revere Medical's relationship with its private equity backer, Kinderhook's expectations for the physician practice, and how regulators can think of the practice differently than Stewardship.
"I can understand why you have a feeling of being gun-shy with private equity, and I'm sorry that you have that feeling -- if you have a position on private equity, I don't want to change that, I can't change that," Sloan said. "My relationship with Kinderhook is I'm an operator for them, and they are an investor for me, to provide me and my team the capital to execute the mission and vision that I've already laid out."
WBJ Web Partners
Most Recent
Most Recent
0 Comments