Taylor plans fall 'retreat' to ponder health regulation Reform efforts stalled last session amid disputes over details

Health care

July 29, 1998|By M. William Salganik | M. William Salganik,SUN STAFF

House Speaker Casper R. Taylor Jr. said yesterday that he plans to convene a "legislative retreat" in the fall to consider health regulatory reform.

In addition to being attended by key legislative leaders, he said, the meeting would include representatives from the state hospital association, the state medical society, the health maintenance organization industry and other interest groups.

A Taylor-backed regulatory reform bill attracted wide support in the last legislative session but stalled at the end amid disputes over details.

Regulatory reform got another push last week when William L. Jews, chief executive officer of CareFirst Inc., the holding company for Blue Cross and Blue Shield of Maryland, released several consultant studies arguing that regulation produced inefficiencies in the Maryland health system and added to hospital costs.

For example, the consulting firm Arthur Andersen concluded that Blue Cross overpays for hospital care in Maryland by 38 percent, or about $80 million a year, compared with national "best practice" benchmarks.

Another Blue Cross-sponsored study, by Lewin Group Inc., estimated that the average hospital case in Maryland costs 19 percent more than the national average, based on statistical analyses of Medicare cost reports.

Jane E. Ruseski, deputy director for research and methodology for the Health Services Cost Review Commission, said Medicare cost reports are not the best data for analyzing Maryland costs. The commission's data show the average hospital stay in Maryland costs about as much as the national average.

And the Maryland Hospital Association said Maryland's average hospital stay, number of hospital beds per capita and number of hospital days per capita are below national averages.

Although there was some dispute over the figures in the Blue Cross studies, there is general support for streamlining Maryland's regulatory system, which involves the Department of Health and Mental Hygiene, the Insurance Administration and three commissions, one to regulate hospital rates, one to determine what new services are needed and one to monitor health access.

Calvin M. Pierson, president of the Maryland Hospital Association, said that though his organization is battling with Blue Cross over claims payments, when it comes to regulatory reform, "we're not all that far apart, even on rate-setting issues."

Don S. Hillier, chairman of the Health Services Cost Review Commission, which sets hospital rates, said yesterday that he welcomes the Taylor retreat. His panel is planning a retreat in September to consider how it can control hospital costs better, he said.

Taylor said his session would be "asking the threshold question of where do we want to be in Maryland 10 years from now. If we can reach consensus, the next question is how do we incrementally get there. Then we can outline a legislative strategy."

He said he hopes that any reform would retain key aspects of the Maryland system, including a way of paying for hospital care for the uninsured.

The speaker also said that, although some commissions might be combined, "the professional staff of each is vital" and should be retained.

Pub Date: 7/29/98

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