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GBIO Wins Unprecedented Price Caps, Saving Consumers $1B From Healthcare Systems Merger

Photo of Attorney General Maura Healey at GBIO Oct. 22nd 20th Anniversary action
As part of a court-filed consumer protection agreement negotiated between Massachusetts Attorney General Maura Healey and Beth Israel Lahey Health (BILH), Massachusetts consumers and taxpayers will save over one billion dollars of healthcare costs over the next seven years as a result of price caps established in response to action by the Greater Boston Interfaith Organization (GBIO). The cost savings are based on a report by the Massachusetts Health Policy Commission, a state research agency established by law championed by GBIO in 2012.
Beth Israel and Lahey Health Systems and a combination of 13 hospitals have been attempting to merge into a single healthcare system since the beginning of 2017. By forming the second largest healthcare system in Massachusetts, BILH believes it will be better able to compete against Partners Healthcare, the dominant healthcare system in Massachusetts. GBIO has been fighting for consumers and taxpayers to ensure that the merger would not cause a dramatic increase in costs. When the Health Policy Commission predicted that the merger would drive up healthcare costs by as much as $230 million dollars per year, GBIO challenged Attorney General Maura Healey and other state agencies to protect consumers from this outrageous increase in cost.
At the Fall GBIO Action, held on October 22nd at the Islamic Society of Boston Cultural Center, Attorney General Maura Healey engaged with over 1400 people representing 43 GBIO member institutions. GBIO leaders called for and Attorney General Healey promised to fight for conditions “with teeth” in the proposed merger, to protect consumers from increasing costs and declining access, particularly for low income and communities of color. You can see Attorney General Healey’s response to our action and our call for her to stay strong during her negotiations.
On November 29th, she announced an unprecedented seven-year price cap to ensure that Beth Israel Lahey Health does not take advantage of its market power to increase its prices. These prices are established as BILH negotiates with health insurance companies which then pass on increased costs to consumers in the forms of higher premiums and higher out-of-pocket costs.
Price caps such as these have never been negotiated as part of a healthcare market transaction in Massachusetts. In addition to the price caps, other demands of GBIO, such as improved access for the Massachusetts Medicaid population and $72 million in support of lower-cost settings for healthcare, were included as part of the agreement between Attorney General Healey and BILH.
In an interview with WBUR radio, Bonny Gilbert, co-chair of the GBIO healthcare action team, said, "We would like to see this kind of stronger language at least be the beginnings of more constraints on Partners and some of the other health care providers." And, says Gilbert, the caps must not be allowed to expire for BILH.
Additional link: WCVB Channel 5 highlighted GBIO’s involvement in this merger. 

Lake County United Wins an Additional 100 Inpatient Beds for Behavioral Hospital in Waukegan

Christa Haberkorn speaks to City of Waukegan Planning Zoning Commission about the losing her job due to long distance travel to seek medical care for her daughter.
Lake County United successfully pressed for approval of adding 100 more inpatient beds at the new behavioral hospital in Waukegan, IL.  Lake Behavioral Hospital will now have 146 beds and committed to serve adults and adolescents regardless of ability to pay.  Picture of hospital below.

LI-CAN Wins Expansion of Medication-Assisted Treatment

Medical leaders and practitioners attend LI-CAN’s Medication-Assisted Treatment conference to fight opioid addiction.
Long Island CAN made major strides this month in its campaign to get life-saving medical care for the thousands of opioid users on Long Island, whose addiction exposes them to increasingly lethal synthetic opioids.
More than 100 medical leaders and practitioners attended LI-CAN’s March 17th conference on medication-assisted treatment (MAT) for opioid addiction.  MAT is the medical standard of care for opioid addiction, but most opioid users don’t receive it.  Instead the prevailing approach is abstinence-based treatment which, for 90% of clients, leads to a relapse within 3 months of discharge from treatment.
LI-CAN is working to remove the barriers to MAT in the medical profession, the criminal justice system, insurer practices, and the treatment system.  Three breakthrough wins were announced or achieved at the conference:
  • The region’s two largest hospital chains will begin providing MAT to opioid users in their emergency departments (EDs).  LI-CAN asked the chains to change their ED protocols in 2017 after hearing story after story of opioid users overdosing fatally after being discharged quickly from EDs when they survived previous overdoses.  “We asked them to stop missing these opportunities to interrupt the deadly progression of this disease,” said LI-CAN Co-chairperson Rev. Gideon Pollach.  “We brought them a proposal based on a Yale study showing you can save lives by starting MAT in the emergency room, instead of just discharging these patients with a referral to treatment.  Now that the two biggest chains have said yes, we will work to make this the standard approach to handling opioid overdoses in the ED.”
  • 30 doctors, nurse practitioners and physician assistants received training needed to receive a federal waiver to prescribe buprenorphine, a highly effective MAT drug.  These new prescribers will help alleviate the shortage of practitioners offering the drug on Long Island.
  • A group of veteran MAT practitioners launched a groundbreaking MAT Learning Collaborative to provide ongoing peer support, education and clinical mentorships for fellow practitioners.  “A learning collaborative is one cornerstone to a functioning MAT infrastructure on Long Island,” said Dr. Leslie Marino, an addiction psychiatrist who has served as LI-CAN’s medical advisor.
Building on these successes, LI-CAN will now expand its work to root out the stigma and bias against MAT throughout the criminal justice system.

GCC wins Medicaid Expansion in Ohio

Greater Cleveland Congregations takes much credit for Medicaid Expansion in Ohio, which gives an additional 275,000 Ohioans access to Health Care.  Starting in 2012, GCC created the NEO-MEC coalition with hospitals and other interests, held a 1200-person Assembly at Olivet Institutional Baptist Church to show our support for expansion, lobbied in Columbus 4 times, wrote thousands of letters and made phone calls to our legislators, filled 3 busses on 3 days’ notice to rally on the Statehouse steps, canvassed in 3 local swing districts to urge voters to contact their legislators, wrote an op-ed in the Plain Dealer, and collected 2,500 signatures in 3 weeks during a ballot initiative.

On October 21st, the Controlling Board voted to approve the federal funds to expand Medicaid, and on December 21st, the Ohio Supreme Court upheld this decision. 

Common Ground Health Care Co-op Enrollment Surges

Common Ground Healthcare Cooperative, a creature of an Obamacare initiative for nonprofit customer-owned health plans, has enrolled more than 2,200 Wisconsinites so far — and 75 percent to 80 percent of them enrolled via the online health-insurance marketplace.

Bob De Vita, chief executive officer of Brookfield-based Common Ground, said he is confident the co-op will meet his goal of signing 10,000 people by the end of 2014.

Common Ground Launches Healthcare Cooperative

Common Ground Healthcare Cooperative

Common Ground IAF in Southeastern Wisconsin has a solution to skyrocketting healthcare costs: the formation of their own health insurance company: The Common Ground Healthcare Cooperative (CGHC).

Targeting small businesses, non-profits and individuals in the seven counties of Southeastern Wisconsin, the non-profit, member governed cooperative will launch January 1, 2014. The cooperative is funded with a $56 million loan from the federal government through the Affordable Care Act.

Non-profit means any surplus will be invested back into the company for the benefit of its members, helping keep premium costs lower. The organization focuses on working with doctors, hospitals, agents and members so that the best healthcare can be provided at a reasonable rate. A member elected board of directors will give participants a say in how the cooperative operates and – by keeping the books transparent – each individual will know exactly what their premium is used for.

Together the CGHC and Common Ground have initiated the process of enrolling 25,000 to 50,000 between 2012 and 2017.

GBIO Health Care Cost Containment Action

  Over 200 GBIO leaders gathered major health providers, insurers, and healthcare system officials to examine their progress in adhering to the targets of landmark health care cost containment legislation passed in 2012.

The action received extensive coverage from major media:

Could Medicaid expansion decrease drug court costs, save local taxpayer dollars? Cleveland judge says yes.

CLEVELAND, Ohio -- Cuyahoga County Common Pleas Judge David Matia estimates that area residents could save millions in local taxes if the offenders he sees in drug court had health insurance. And if Ohio were to expand Medicaid, as being debated by state legislators, many of the defendants in his court would qualify for the state a

Governors Fall Away in G.O.P. Opposition to More Medicaid

Under pressure from the health care industry and consumer advocates, seven Republican governors are cautiously moving to expand Medicaid, giving an unexpected boost to President Obama’s plan to insure some 30 million more Americans.... Every few days, state hospital associations and advocates for poor people issue reports asserting that the economic benefits of expanding Medicaid would outweigh the costs.