Q&A: MA Lawmaker on Cost Containment

Q. Is there one provision of the law that you view as particularly important?
A. Well, like any good research paper, we always need to have more studies. We'll have a commission look at the variation of price. We want to know why there are price differences for a particular procedure. We've seen cases where the same physician will have different charges for the same procedure. We need a better understanding of pricing.

We know some of it is market share, but there are other reasons. We're looking for a way to compare apples to apples instead of just looking at prices and saying they are different. There are probably valid reasons for the price differences but we want to understand the value to the patient and health system that justifies those differences.

Another study group will look at the issue of diagnosis. Studies suggest that 15% to 44% of diagnosis are generally are wrong. If that's true then people are getting treatment that doesn't do them any good because the diagnosis is incorrect. What can we do about that?