Would you take a virtual walk with me across the Dartmouth Atlas map on RWJF's web site? Just follow the link. Now, move your cursor first over, say, anywhere in Minnesota. There, you'll see that 2006 Medicare reimbursements were roughly $6,700 per beneficiary. Now, move your cursor across the country, way over to Massachusetts–specifically, Boston, for instance. There, 2006 Medicare reimbursements were almost a whopping $3,000 per beneficiary higher. You'd sure think that the quality of care in Massachusetts must be extraordinarily better for that extra $3,000 per person–but, guess what? It's not–it's roughly the same–maybe even worse in some cases. Plus, Massachusetts has embarked on its own universal coverage experiment. First in its class, Massachusetts is providing the rest of us with a real-world unfolding example demonstrating how health care cost, quality, value, and coverage intersect. If Massachusetts could figure out how to pay for high-quality care at the level of, say, Minnesota, their coverage experiment might just get exponentially easier.
So, are our national leaders taking this unfolding lesson to heart? We're beginning to learn. Last week the Senate Finance Committee released a set of policy options on transforming the health care delivery system. Their statement is really the first glimpse we've had at how our national leaders might (or might not) be linking value and coverage.