Market Oversight and Transparency (MOAT)
The Market Oversight and Transparency (MOAT) department, led by Kate Scarborough Mills, Esq., MPH, is responsible for advancing the HPC’s statutory charge to encourage a more value-based health care market. This includes (1) developing and implementing a first-in-the-nation Registration of Provider Organizations (RPO) program to provide transparency on the composition and function of provider organizations in the health care system, (2) tracking and evaluating the impact of significant health care provider changes on the competitive market and on the state’s ability to meet the health care cost growth benchmark through review of material change notices (MCNs) and cost and market impact reviews (CMIRs), (3) evaluating the performance of individual health care providers and payers which threaten the health care cost growth benchmark and overseeing Performance Improvement Plans (PIPs) to improve the cost performance of such entities, and (4) collaborating with other HPC departments to catalyze improvements in the performance of the health care system.
About the Director
Katherine (Kate) Scarborough Mills leads the Massachusetts Health Policy Commission’s (HPC) MOAT work, advancing the HPC’s statutory charge to encourage a more value-based health care system by increasing the transparency of and catalyzing improvements in the performance of the health care market.
In her role as the director of the HPC’s MOAT team, Ms. Mills manages a team of attorneys, economists and other health care policy experts and oversees the HPC’s reviews of changes to the health care market in Massachusetts (material change notices and cost and market impact reviews), compliance with and enforcement of the state’s health care cost growth benchmark through performance improvement plans, the state’s registration of provider organizations program designed to increase transparency on the structure and functioning of the health care provider market in Massachusetts, and various special projects related to health care market functioning in Massachusetts including work on variation in provider prices, out-of-network billing, and the state of community hospitals. In her previous roles as the HPC’s Project Manager and Deputy Director for Cost and Market Impact Reviews, Ms. Mills worked on designing Massachusetts’ first-in-the-nation cost and market impact review process and led the HPC’s first cost and market impact reviews, focused on the proposed expansion of the Commonwealth’s largest provider organization. Prior to joining the HPC, Ms. Mills was an attorney and health care policy and budget analyst with the Massachusetts Senate Committee on Ways and Means where she worked closely on Chapter 224 of the Acts of 2012, the state’s landmark health care cost control legislation, as well as other health care, public health, and mental health legislation. Ms. Mills earned her A.B. from Harvard College, her J.D. from Northeastern University School of Law, and her M.P.H. from Tufts Medical School.