Massachusetts Health Cost-Control Bill Contains First-in-Nation Fund for Prevention Programs

A coalition of consumer and public health groups applauded the inclusion of money in the health cost-control bill adopted by lawmakers Tuesday to pay for programs to stem chronic illnesses such as diabetes, asthma, and heart disease that are fueling the growth of medical costs.

The $60 million earmarked over the next four years for the Prevention and Wellness Trust, believed to be the first such state-based prevention fund in the nation, will be paid for by a tax on insurers and an assessment on some larger hospitals.

Under the expansive prevention program, communities, health care providers, regional-planning agencies, and health plans will be able to vie for grants, to be awarded by the state’s Department of Public Health, to battle preventable illnesses.

The money will also be used to help employers launch work-based wellness programs. The bill creates tax credits for employers that set up the programs, and it also requires health insurance premium discounts for small businesses with these programs.

Supporters, who long lobbied for money to be dedicated to disease prevention as part of cost-control legislation, called the bill groundbreaking.

“This keeps Massachusetts at the forefront of health policy,” said Maddie Ribble, policy director at the Massachusetts Public Health Association.

Health Care for All, a Boston-based consumer group, said in a statement that the legislation “will begin to move us away from a sick care system and towards a true health care system that is aligned and focused on keeping us healthy.”

But health insurers and hospital leaders are not keen on the assessments that will fund the health prevention programs, saying the fees will ultimately drive up costs.

“While we support the concept of a public trust fund, we have long felt that this is something that should have been funded by the state, not through an assessment on insurers and employers,” said Eric Linzer, spokesman for the Massachusetts Association of Health Plans, a trade group. “Ultimately these types of assessments increase the cost of health care.”

Lynn Nicholas, president and chief executive of the Massachusetts Hospital Association, said in a statement that the proposed use of the money is “laudable,” but that the association is “opposed to the imposition of surcharge assessments on hospitals and will continue to advocate that the additional cost of implementing the bill not be placed upon providers who are already underpaid by government payors and working diligently to lower costs.”

The bill also requires that a 20-member commission be established to evaluate the effectiveness of the new prevention programs and whether health care costs were, in fact, reduced. It requires the commission to hire an outside organization to conduct the evaluation, and also requires that the results of that review be posted on the state’s website no later than June 30, 2015.

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