Two years ago, Massachusetts set what was considered : The state would not let that persistent monster, rising health care costs, increase faster than the economy as a whole. Today, the 听are out and there鈥檚 reason to for many to celebrate.
The number that will go down in the history books is 2.3 percent. It鈥檚 well below a state-imposed benchmark for health care cost growth of 3.6 percent, and well below the increases seen for at least a decade.
鈥淪o all of that鈥檚 really good news,鈥 says Aron Boros, executive director at the Center for Health Information and Analysis (CHIA), which is releasing the first calculation of state health care expenditures. 鈥淚t really seems like鈥he growth in health care spending is slowing.鈥
Why? It could be the pressure to comply with of the federal health law in its first year.
鈥淲e have to believe that鈥檚 the [first] year,鈥 Boros says, 鈥渢hat insurers and providers are trying their hardest to keep cost increases down.鈥
But then, health care spending growth slowed across the U.S., not just in Massachusetts, last year.
鈥淭here鈥檚 not strong evidence that it鈥檚 different in Massachusetts; we really seem to be in line with those national trends,鈥 Boros adds. 鈥淧eople are either going to doctors and hospitals a little less frequently, or they鈥檙e going to lower-cost settings a little more frequently.鈥
The result: Health insurance premiums were basically flat overall in the state in 2013.
鈥2013 was a year in which we were able to exhale,鈥 says Jon Hurst, president of the Retailers Association of Massachusetts. But he鈥檚 worried the break on rates was short-lived. This year, Hurst鈥檚 members are reporting premium increases that average 12 percent.
鈥淚f we鈥檙e going back to these double-digit increases that so many small businesses suffered through for most of the last decade, we have very large concerns,鈥 Hurst says. 鈥淲hat鈥檚 going to happen to the small business marketplace in Massachusetts?鈥
Premiums are up for many individuals and small businesses this year and are because of new requirements under the Affordable Care Act 鈥 because patient demand for care is picking up again as the economy improves and because of a few new, expensive drugs.
Rick Lord, president of Associated Industries of Massachusetts, says his members continue to rate health care costs as their top concern.
鈥淭hat鈥檚 not a big surprise,鈥 Lord says, 鈥渂ecause even though we came off a year where increases were pretty modest, we also know that health care costs on a per-capita basis are the highest in the country, so that puts [employers in Massachusetts] at a competitive disadvantage.鈥
All in all, 鈥渨e have to be impressed with the numbers,鈥 says Stuart Altman, who chairs the Health Policy Commission, the group created to monitor health care spending.
鈥淲hat is of concern though is that Blue Cross [Blue Shield], which is our largest insurer, seems to be significantly higher in terms of the rate of growth than the others,鈥 says Altman. The CHIA report said that BCBS spending increased 3.7 percent.
Blue Cross Blue Shield of Massachusetts said in a statement that while it had not seen the report, the numbers are not an accurate reflection of the year-over-year increase in health care spending. Blue Cross said that its own calculation, using numbers that are not adjusted for patient health status, shows a 2.1 percent increase. CHIA鈥檚 used data that is adjusted for health status.
Among providers, Altman and Boros point out the state鈥檚 largest group of physicians, those tied to Partners HealthCare hospitals, were among the highest paid and had the greatest increase in spending last year.
鈥淲e鈥檙e going to be looking at that to see to what extent it could be justified or whether it reflects the fact that they are continuing to use their market power to get higher rates,鈥 Altman says.
鈥淧artners experienced great success in 2012, actually lowering the cost of care for our patients鈥 by nearly a percentage point,鈥 according to Partners spokesman Rich Copp. 鈥淚n 2013, the trend did grow faster than expected and we know that there is more work to do in the coming years. But over the long term, our approach to the delivery of health care services, delivering more coordinated care in community settings, will make care more affordable for patients.鈥
