Bill > H1372

This bill introduces a new metric called Weighted Average Payer Rate (WAPR) to enhance health care cost accountability in Massachusetts. The WAPR is a complex calculation that separately determines inpatient and outpatient revenue per discharge/visit for three types of payers: Commercial, Medicare, and Medicaid, and then creates a weighted average using the Net Patient Service Revenue payer mix. The legislation amends several sections of existing law to incorporate this new metric, requiring public hearings and reports that will now explicitly examine and disclose WAPR alongside other cost and price data. These changes will mandate that the state's health care commission conduct annual public hearings that analyze health care expenditure growth, compare provider and payer costs, and include detailed testimony about payment systems, care delivery models, and cost structures. The bill aims to increase transparency by requiring reporting on the weighted average payer rates for acute hospitals and physician organizations, with the ultimate goal of providing more comprehensive insights into health care pricing and potentially identifying opportunities to control rising medical costs.

Health and Social Services

https://malegislature.gov/Bills/194/H1372