With MassHealth requiring an expanding portion of the state budget each year – approximately 40 percent in fiscal 2018 – there is general agreement on Beacon Hill that health care costs need to be addressed in a substantive way.
Gov. Charlie Baker proposed some health care cost containment measures in his fiscal 2018 budget proposal, but the Legislature chose to remove those sections from the budget to allow for a more thorough discussion and legislative process on the issue.
Over the past few months, the Senate has hosted multiple roundtable discussions to assess steps that other states have taken to address the issue. While a bill is still being drafted, with language expected in early October, MMA staff have been meeting with Senate legislative staff to ensure that municipal concerns are addressed.
Municipalities struggle each year to balance budgets while facing large percentage increases in health costs, with few tools available to rein in those costs. The MMA has been advocating that cities and towns should have access to whatever tools the Senate includes in its health bill for the state to control its costs. If the bill merely shifts costs from the state to municipalities, it won’t effectively achieve the intended goal of containing growth in health care costs.
Two issues that have been part of Senate health care discussions are ambulance fees and mobile integrated health. Neither is a major factor affecting  health care cost growth, but both serve as good examples of small expected changes to current practices and a new way of providing care.
Legislation concerning ambulance fees has been filed repeatedly for the past few sessions. The goals of these bills have been to eliminate “pay the patient” practices by insurers, and to establish that the appropriate rate to be reimbursed for emergency medical transport is the rate set by the municipality in which the trip originates. This issue is expected to be addressed in the Senate bill or by amendment as the bill moves through the legislative process.
Mobile integrated health care is the practice of using community-based services, including EMS, to offer a broader array of health care services, including, but not limited to, pre- and post-hospital check ups, preventative care screenings, and routine check-ins for individuals with long-term health issues. The goal is to avoid unnecessary hospital transports and emergency room visits, both of which contribute to increased health care spending.
Other elements that will be included in the health bill should be revealed in the coming weeks.

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