Press Release  HPC RECEIVES PERFORMANCE IMPROVEMENT PLAN PROPOSAL FROM MASS GENERAL BRIGHAM

BOSTON — Yesterday, Mass General Brigham (MGB) filed its performance improvement plan (PIP) proposal with the Massachusetts Health Policy Commission (HPC). In January, MGB was required to develop a performance improvement plan after the HPC identified significant concerns regarding MGB’s spending performance, noting that MGB’s spending growth has likely already impacted the state’s ability to meet the health care cost growth benchmark and, unless addressed, is likely to continue to impact the state’s ability to meet the benchmark. The proposal is required to include specific strategies and action steps to improve MGB’s spending performance.

A copy of the proposed PIP can be found here.

“The performance improvement plan process is a key accountability and transparency mechanism for the state’s health care cost growth benchmark,” said David Seltz, HPC Executive Director. “The HPC will carefully analyze MGB’s proposal and evaluate its likelihood to achieve our shared goal of delivering meaningful and sustainable health care cost savings. We look forward to working together to reduce health care costs for the people of the Commonwealth.”

The PIP proposes a total health care savings target of $105 million over the 18 month period of performance (or, $70 million annually). The proposal describes four strategies producing $70 million in reduced health care spending annually, including:

1. Reducing Utilization - $10.8 million
2. Shifting Care to Lower Cost Sites - $5.3 million
3. Price Reductions - $53.8 million
4. Enhancing Accountability through Value-Based Care

The HPC will review the proposal filed by MGB and will approve the plan upon a determination that it is reasonably likely to successfully address the underlying causes of the MGB’s cost growth, and that MGB is capable of successfully implementing the plan. The HPC’s Board will consider whether to approve MGB’s proposal at an upcoming Board meeting.

BACKGROUND

At its January 25, 2022 meeting, the HPC summarized findings from an extensive examination of MGB’s spending performance, including that from 2014 to 2019, MGB’s primary care patients had more cumulative commercial spending in excess of the benchmark than any other provider, totaling $293 million. At the time, commissioners noted that MGB’s ongoing cost-control strategies did not appear to have reduced its commercial spending growth to below-benchmark rates. The HPC then took action to hold MGB accountable under state law, voting unanimously to require that MGB develop and implement a performance improvement plan that will result in meaningful, cost-saving reforms.

This was the first PIP to be required from a provider or health plan by the HPC.

In March, MGB submitted a 60-day extension request and the HPC approved the extension at the April 13, 2022 Board meeting.

More information, including a copy of the PIP proposal and an overview of the PIP process and timeline are available on the HPC’s website.

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