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SENATE DOCKET, NO. 543 FILED ON: 1/17/2023
SENATE . . . . . . . . . . . . . . No. 802
The Commonwealth of Massachusetts
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PRESENTED BY:
Michael F. Rush
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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act to improve health care cost accountability.
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PETITION OF:
NAME:DISTRICT/ADDRESS :Michael F. RushNorfolk and SuffolkVanna Howard17th Middlesex1/31/2023Paul McMurtry11th Norfolk2/8/2023 1 of 3
SENATE DOCKET, NO. 543 FILED ON: 1/17/2023
SENATE . . . . . . . . . . . . . . No. 802
By Mr. Rush, a petition (accompanied by bill, Senate, No. 802) of Michael F. Rush, Vanna
Howard and Paul McMurtry for legislation to improve health care cost accountability. Health
Care Financing.
[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE SENATE, NO. 812 OF 2021-2022.]
The Commonwealth of Massachusetts
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In the One Hundred and Ninety-Third General Court
(2023-2024)
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An Act to improve health care cost accountability.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Section 1 of Chapter 224 6D of the Acts of 2012 is amended by adding the
2following:-
3 “Weighted Average Payer Rate” or “WAPR”, a measure by which a sum of the inpatient
4revenue per discharge and outpatient revenue per visit is separately calculated for Commercial,
5Medicare, and Medicaid. A weighted average of the three resulting values is derived, with the
6Net Patient Service Revenue - based payer mix of the three payers serving as weights.
7 SECTION 2. Section 8(a) of Chapter 224 6D of the Acts of 2012 is amended by striking
8out Section 8(a) and adding the following 2 of 3
9 (a)Not later than October 1 of every year, the commission shall hold public hearings
10based on the report submitted by the center for health information and analysis under section 16
11of chapter 12C comparing the growth in total health care expenditures to the health care growth
12benchmark for the previous calendar year. The hearings shall examine health care provider,
13provider organization, and private and public health care payer costs, prices, weighted average
14payer rates, and cost trends, with particular attention to factors that contribute to cost growth
15within the commonwealth’s health care system.
16 SECTION 3. Section 8(e) of Chapter 224 6D of the Acts of 2012 is amended by striking
17out Section 8(e)(i) and adding the following
18 (i) in the case of providers and provider organizations, testimony concerning payment
19systems, care delivery models, payer mix, cost structures, administrative and labor costs, capital
20and technology cost, adequacy of public payer reimbursement levels, reserve levels, utilization
21trends, relative price, weighted average payer rate, quality improvement and care-coordination
22strategies, investments in health information technology, the relation of private payer
23reimbursement levels to public payer reimbursements for similar services, efforts to improve the
24efficiency of the delivery system, efforts to reduce the inappropriate or duplicative use of
25technology and the impact of price transparency on prices
26 SECTION 4. Section 13(d) of Chapter 224 6D of the Acts of 2012 is amended by striking
27out Section 10(d)(v) and adding the following
28 (v) provider cost and cost trends including the weighted average payer rate in comparison
29to total health care expenditures statewide 3 of 3
30 SECTION 5. Section 13(d) of Chapter 224 6D of the Acts of 2012 is amended by striking
31out Section 13(d)(xii) and adding the following
32 (xii) the weighted average payer rate paid to each acute hospital and physician
33organization; (xiii) any other factors that the commission determines to be in the public interest.
34 SECTION 6. Section 1 of Chapter 224 12C of the Acts of 2012 is amended by inserting
35the following
36 “Weighted Average Payer Rate” or “WAPR”, a measure by which a sum of the inpatient
37revenue per discharge and outpatient revenue per visit is separately calculated for Commercial,
38Medicare, and Medicaid. A weighted average of the three resulting values is derived, with the
39Net Patient Service Revenue- based payer mix of the three payers serving as weights.
40 SECTION 7. Section 10(b) of Chapter 224 12C of the Acts of 2012 is amended by
41inserting following section
42 (12) the weighted average payer rate paid to each acute care hospital and physician
43organization
44 SECTION 8. Section 16(a) of Chapter 224 12C of the Acts of 2012 is amended by adding
45the following after the words “patient centered medical homes.”
46 (6) the weighted average payer rate paid to each acute care hospital, and physician
47organization, respectively.