Press Statement  Statement of Auditor Suzanne Bump on the Center for Health Information and Analysis Annual Report

Boston — Auditor Suzanne M. Bump released the following statement on CHIA annual report:

"The annual report released yesterday by the Center for Health Information and Analysis  points to a 19 percent spending spike in MassHealth, the state’s Medicaid program, as a driving force behind the 4.8 percent increase in healthcare costs in 2014. This spike, in turn, is the result of increased membership associated with the state’s implementation of the Affordable Care Act. Already the biggest program in Massachusetts, MassHealth makes up about one-third of the state’s budget and serves more than 1.5 million people.

Culling ineligible members from the rolls will help, but our audits of MassHealth clearly indicate the urgent need for a changed management culture and significant operational changes. In the last four years, our audits have identified more than $619 million in waste, possible fraud, and lost opportunities for savings that have resulted from weak policies and procedures and lax administration.  We cannot expect MassHealth to turnaround overnight, but we can demand that the agency address the persistent problems which contribute to runaway costs. We all want this program to be successful and to serve those who need it."

Background: Healthcare is major focus of the Office of the State Auditor, not only through our frequent audits of the MassHealth program and our annual report to the legislature, but also in our examination of healthcare cost containment, as part of Chapter 224, the same legislation that created CHIA. Our report on health care cost containment is due to the Legislature in 2017, but we have already begun to analyze the huge swaths of data for this project.  The Legislature saw the value in our work at MassHealth and appropriated $300,000 in additional funding for the Medicaid Audit Unit in the 2016 state budget.