Commonwealth Magazine

Andrew Dreyfus, who is ending his 12 years as president and CEO of Blue Cross Blue Shield of Massachusetts, says health care costs in the state are about to explode.

Some of the increase is justified, as healthcare providers grapple with inflation, labor shortages and supply chain challenges. But Dreyfus cautions that the state’s voluntary health care cost benchmark won’t do much to control the situation.

“I think that’s really at risk now,” he said on The Codcast with John McDonough of the Harvard TH Chan School of Public Health and Paul A. Hattis of the Lown Institute. “Hospitals that used to negotiate with us with an eye toward the benchmark and not exceeding it have been very explicit with us that it is not relevant today. Many of them have been asking for increases of four to five times the size of the benchmark.”

Dreyfus predicts that health insurance premiums will grow at double-digit rates, employers will refuse to pay, and the government will be pressured to intervene with price controls or some other regulatory response, most likely initiated by the Health Policy Commission. Health.

Don’t forget, Dreyfus adds, COVID is not going away, and Governor-elect Maura Healey will have to pay close attention to it. “We are just one hard variant away from being in a really challenging situation,” she said.

Dreyfus says that health equity is another pressing issue. He said Blue Cross has spent considerable time in recent years reviewing health disparities within its own system and plans to announce a trial of incorporating equity into the payment model it uses with health providers in the coming weeks.

Hattis and McDonough pressed Dreyfus about health care consolidation, and the insurance executive responded with concern, both about new acquisitions and expansions. He said the evidence is strong that consolidation leads to higher prices, not better quality.

“We should be very careful about any further consolidation without really strict oversight,” he said, noting the importance of the price protections built into the merger that produced Beth Israel Lahey Health. He also said the disjointed regulatory structure for health care expansion requires better coordination between the Department of Public Health, the Health Policy Commission, the Division of Insurance and the attorney general’s office.

“The status quo is not acceptable,” he said, noting that innovation in health care oversight will have to come at the state level given the political stalemate in Washington, DC. (One political shift he noted in recent elections was the lack of meaningful debate over the Affordable Care Act. “It’s a reminder that reform takes a long time to take root,” he said.)

Dreyfus said the health insurance market is also changing, with for-profit companies gaining more market share. McDonough pressed Dreyfus on whether Blue Cross Blue Shield would consider becoming a for-profit company, and Dreyfus said that would not be in the cards. “We really believe in our nonprofit mission,” he said.

But he said massive for-profit companies have many advantages, chief among them the scale to use one line of business to subsidize another. “We believe that nonprofit health plans like Blue Cross, Point 32 and Fallon are good for the community,” she said. “I worry about losing that special quality that we have in Massachusetts.”

Dreyfus will step down at the end of the year and will be succeeded by Sarah Iselin, executive vice president and chief operating officer of Blue Shield of California.



breathalyzer challenge: The Supreme Court is preparing to take up a case questioning whether 27,000 defendants in drunk driving cases should be eligible for new trials due to government misconduct in connection with breathalyzer results. The case is reminiscent of previous ones related to the misconduct of the state pharmacy drug laboratory. Read more.

urine decision: The Supreme Court of Justice dismisses the charges against an inmate who urinated all over the floor of his cell and rules that urine is not a “noxious or dirty substance” according to the law. Read more.


coming clean: Epidemiologist Shira Doron and UCal-San Francisco professor Monica Gandhi say it’s time for a campaign of honesty about the strengths and weaknesses of COVID-19 treatments. Read more.

not cheap anymore: Freelance writer Frederick Hewett believes cheap natural gas is a thing of the past and that the decision not to expand the region’s pipeline capacity looks better and better with each passing day. Read more.

State parks need help: Doug Pizzi of Massachusetts Conservation Voters and Chris Redfern of Friends of the Middlesex Fells join colleagues from 50 other organizations in calling for a significant increase in long-term funding for state parks. Read more.

fixing the T: Caitlin Allen-Connelly of A Better City outlines five steps to changing the MBTA. Read more.

Crying wolf? Richard Moore of Dignity Alliance Massachusetts questions whether nursing homes are as bad as they say. Read more.



Boston is launching a youth safety task force amid an explosion of arrests for possession of firearms. (boston globe)

Wayland’s police chief resigns after a history of whistleblowing and controversy. (live mass)

New Bedford city officials are in a delicate dance as they try to block the opening of a downtown addiction treatment center after years of efforts to revive the district, without triggering a legal challenge from the potential center based in the Americans with Disabilities Act. (New Bedford Light)

Following Amherst’s lead, a group of advocates in Northampton are calling on the City Council to create a reparations commission to examine historical links to slavery and racism and address current inequalities. (Hampshire Daily Bulletin)


Western Massachusetts hospitals, like others across the state, are suffering from staff shortages. (live mass)

A new commission will study the history of Massachusetts state institutions for the mentally ill. (live mass)

A new study involving Boston University researchers aims to understand the genetic and other factors behind the longevity of the “super-aged,” those who live well into their 90s and beyond in relatively good health. . (boston globe)


Suffolk pollster David Paleologos says 41 percent of those who backed Chris Doughty in his losing Republican primary bid for governor switched to support Democrat Maura Healey in the general election, one of many data points that they signal the downward spiral of the Mass GOP. (boston herald)


As marijuana prices fall, some marijuana stores may close. (Telegram and Gazette)


The Boston Public Schools have expelled 15,000 black students in the past 20 years. (boston globe)

Librarians are experiencing increased challenges for books with content deemed inappropriate for young readers by parents or outside groups. (Salem News)


The state distributes $12 million in grants to remove dams and improve water hydrology and the local ecosystem. (Salem News)

Oh jesus:. A new study shows that southeastern Massachusetts cities, led by Middleborough and Westport, had the most car and deer collisions in 2021. (boston globe)


Advocates say they are alarmed that officers accused of misconduct on one job are simply moving on to jobs in other communities. (WBUR)


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