You Tin Entirely Milk Shiver Your Caput Together With Wonder
Friday, October 15, 2021
The Attorney General's 73-page filing amongst the Court nearly her (now slightly revised) bargain amongst Partners Healthcare System deserves at to the lowest degree 73 pages of rebuttal, exactly that isn't going to happen. You see, equally noted inward Commonwealth Magazine:
The timing of Coakley's response seemed designed to maximize her aggressive response to her critics too minimize pushback. Her aides released the amended deal, the comments on the master copy deal, too her responses to them at v p.m. on Thursday, likewise belatedly for her critics to respond. If they produce respond on Friday, the tidings volition air over the weekend, when fewer people volition endure paying attention. On Monday, Coakley's understanding amongst Partners goes to Suffolk Superior Court Judge Janet Saunders for review.
Then, when it gets to Court, at that spot are exclusively 3 other parties who pick out a correct to endure heard:
Partners Healthcare System;
South Shore Health too Educational Corporation, which is seeking to endure acquired yesteryear PHS; and
Hallmark Health Corporation, which is seeking to endure acquired yesteryear PHS.
That's right. This is share of a procedure that has been termed "transparent" yesteryear the Attorney General's office:
Step 1: Negotiate too sign a bargain amongst PHS inward secret;
Step 2: Present it to the Court;
Step 3: Suggest to the Court that comments should endure allowed--but exclusively afterwards the Greater Boston Interfaith Organization set pressure level on her to permit those world comments;
Step 4: Revise the bargain inward a few tike ways, respond to Earth comments, too introduce them to the Court without allowing a peril for rebuttal from other interested parties;
Step 5: Oppose intervention yesteryear other parties inward the courtroom case.
But it gets worse still. Just read this paragraph from page 46 of the AG's filing [emphasis added]:
Several comments suggest that the comprehensive cost caps produce non produce plenty to cut back the gap betwixt Partners electrical current reimbursement rates too the prices of other wellness assist providers, that is, to fight the “provider cost disparity” that has been good documented inward Massachusetts (initially yesteryear the Attorney General’s Office). This is non an appropriate lens through which to evaluate this remedy. These comments seem to suggest that the UPGC [unit cost growth cap, which limits PHS cost increment to the lower of full general or medical inflation] should cutting dorsum on the pricing payoff that they attribute to Partners’ electrical current marketplace position. But the remedies inward the proposed Consent Judgment cannot endure evaluated compared to claims that the Attorney General did non bring. Rather, the mensurate of the UPGC is whether it addresses the harms identified inward the Complaint.
This paragraph boggles the mind. The AG spent several years documenting the fact that Partners' marketplace mightiness is responsible for the substantially higher rates it receives from insurers for the same operate done yesteryear other academic medical centers, community hospitals, too physicians. Indeed, she concluded that this disparity has been i of cardinal drivers of wellness assist cost increases inward Massachusetts. She does non suggest inward her filing that the UPGC volition cut back the disparity--and indeed it volition not.* Instead, she argues that this theme is irrelevant to the electrical charge she initially filed against PHS.
The obvious enquiry is why she never included this facial expression of Partners' marketplace mightiness inward her electrical charge too why she did non seek a remedy to it.
Oh, here's the answer she offers (on page xxx too elsewhere):
If nosotros don't similar this bargain she has signed, others are gratis to file an anti-trust lawsuit against PHS.
I idea that was her job.
--
* Remember this summary on Commonhealth [emphasis added]:
But volition the bargain unopen the gap betwixt what Brigham too Women’s is paid for that MRI equally compared to Beverly Hospital? Only if the low-cost hospitals larn some pregnant charge per unit of measurement increases.
If Partners prices ascent ii per centum a year, too prices for similar Boston hospitals become upwards 3.6 percent, the gaps narrow, Boros says.
“Specifically, our 2012 data shows that Brigham too Women’s prices are 24 to 33 per centum higher than Beth State of Israel Deaconess Medical Center too 26 to 59 per centum higher than Tufts Medical Center. After half dozen years, these gaps roughly xiii to 21 per centum higher for BIDMC too xv to 45 per centum higher for Tufts,” Boros said.
Of form out that assumes insurers inward Massachusetts would offering lower-cost hospitals charge per unit of measurement increases that are almost twice equally high equally Partners, something they pick out never done before.
And they shouldn’t, says Nancy Kane, who’s been studying infirmary financing inward Massachusetts for to a greater extent than than xxx years too teaches at the Harvard School of Public Health.
“It doesn’t brand the whole to a greater extent than affordable if everybody’s trying to grow their rates,” Kane said. “[The AG's deal] doesn’t address the larger effect of affordability. It’s form of a Band-Aid at this point.”
Kane says if the country wants existent contest amidst hospitals, it would pick out to either ready rates or strength Partners to sell off some of its hospitals.
The timing of Coakley's response seemed designed to maximize her aggressive response to her critics too minimize pushback. Her aides released the amended deal, the comments on the master copy deal, too her responses to them at v p.m. on Thursday, likewise belatedly for her critics to respond. If they produce respond on Friday, the tidings volition air over the weekend, when fewer people volition endure paying attention. On Monday, Coakley's understanding amongst Partners goes to Suffolk Superior Court Judge Janet Saunders for review.
Then, when it gets to Court, at that spot are exclusively 3 other parties who pick out a correct to endure heard:
Partners Healthcare System;
South Shore Health too Educational Corporation, which is seeking to endure acquired yesteryear PHS; and
Hallmark Health Corporation, which is seeking to endure acquired yesteryear PHS.
That's right. This is share of a procedure that has been termed "transparent" yesteryear the Attorney General's office:
Step 1: Negotiate too sign a bargain amongst PHS inward secret;
Step 2: Present it to the Court;
Step 3: Suggest to the Court that comments should endure allowed--but exclusively afterwards the Greater Boston Interfaith Organization set pressure level on her to permit those world comments;
Step 4: Revise the bargain inward a few tike ways, respond to Earth comments, too introduce them to the Court without allowing a peril for rebuttal from other interested parties;
Step 5: Oppose intervention yesteryear other parties inward the courtroom case.
But it gets worse still. Just read this paragraph from page 46 of the AG's filing [emphasis added]:
Several comments suggest that the comprehensive cost caps produce non produce plenty to cut back the gap betwixt Partners electrical current reimbursement rates too the prices of other wellness assist providers, that is, to fight the “provider cost disparity” that has been good documented inward Massachusetts (initially yesteryear the Attorney General’s Office). This is non an appropriate lens through which to evaluate this remedy. These comments seem to suggest that the UPGC [unit cost growth cap, which limits PHS cost increment to the lower of full general or medical inflation] should cutting dorsum on the pricing payoff that they attribute to Partners’ electrical current marketplace position. But the remedies inward the proposed Consent Judgment cannot endure evaluated compared to claims that the Attorney General did non bring. Rather, the mensurate of the UPGC is whether it addresses the harms identified inward the Complaint.
This paragraph boggles the mind. The AG spent several years documenting the fact that Partners' marketplace mightiness is responsible for the substantially higher rates it receives from insurers for the same operate done yesteryear other academic medical centers, community hospitals, too physicians. Indeed, she concluded that this disparity has been i of cardinal drivers of wellness assist cost increases inward Massachusetts. She does non suggest inward her filing that the UPGC volition cut back the disparity--and indeed it volition not.* Instead, she argues that this theme is irrelevant to the electrical charge she initially filed against PHS.
The obvious enquiry is why she never included this facial expression of Partners' marketplace mightiness inward her electrical charge too why she did non seek a remedy to it.
Oh, here's the answer she offers (on page xxx too elsewhere):
If nosotros don't similar this bargain she has signed, others are gratis to file an anti-trust lawsuit against PHS.
I idea that was her job.
--
* Remember this summary on Commonhealth [emphasis added]:
But volition the bargain unopen the gap betwixt what Brigham too Women’s is paid for that MRI equally compared to Beverly Hospital? Only if the low-cost hospitals larn some pregnant charge per unit of measurement increases.
If Partners prices ascent ii per centum a year, too prices for similar Boston hospitals become upwards 3.6 percent, the gaps narrow, Boros says.
“Specifically, our 2012 data shows that Brigham too Women’s prices are 24 to 33 per centum higher than Beth State of Israel Deaconess Medical Center too 26 to 59 per centum higher than Tufts Medical Center. After half dozen years, these gaps roughly xiii to 21 per centum higher for BIDMC too xv to 45 per centum higher for Tufts,” Boros said.
Of form out that assumes insurers inward Massachusetts would offering lower-cost hospitals charge per unit of measurement increases that are almost twice equally high equally Partners, something they pick out never done before.
And they shouldn’t, says Nancy Kane, who’s been studying infirmary financing inward Massachusetts for to a greater extent than than xxx years too teaches at the Harvard School of Public Health.
“It doesn’t brand the whole to a greater extent than affordable if everybody’s trying to grow their rates,” Kane said. “[The AG's deal] doesn’t address the larger effect of affordability. It’s form of a Band-Aid at this point.”
Kane says if the country wants existent contest amidst hospitals, it would pick out to either ready rates or strength Partners to sell off some of its hospitals.