By Michael Norton

State House News Service

BOSTON -- Health-care cost growth in Massachusetts during 2013 held below the 3.6 percent benchmark set under a 2012 cost-control law, but leaders of a state commission overseeing the market are worried about the future.

According to Health Policy Commission Chairman Stuart Altman, many important aspects of the health-care delivery system have not changed since passage of that law and that's "troubling." And commission Vice Chair Wendy Everett says some aspects of the Massachusetts system are "embarrassing" and out of sync with the 2012 law's goals.

At a recent commission meeting at the Statehouse, Altman cautioned that forces that helped keep per-capita cost escalation at 2.3 percent from 2012 to 2013 -- raising total costs from $49 billion to $50.5 billion -- may not be repeated.

Dr. Marian Wrobel, the commission's director for research and cost trends, also said Massachusetts had been riding a national wave of lower cost growth that may not continue.

The Center for Medicare and Medicaid Services projects health-care spending growth rates nationally of more than 5 percent in 2014 and beyond, according to the commission, based on an aging population, the economic recovery, and additional utilization of services among those newly covered under the Affordable Care Act.

The commission in late January adopted far-reaching recommendations, including consideration of whether additional legislative authority is necessary to help the panel determine whether parties in health care transactions -- the Bay State market has undergone significant consolidation in recent years -- have fulfilled efficiency, quality and access commitments made in those deals.

Everett was the most vocal in warning that Massachusetts health-care providers are "outliers" in major areas with implications for costs, including high re-admission and emergency department usage rates and high levels of patients referred to post-acute care, such as nursing, home health or rehabilitative services, after inpatient care.

Eighty percent of Massachusetts hospitals are being penalized for "extraordinarily high" readmission rates, Everett said, calling that "not acceptable."

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Board: Prognosis poor for health-care cost containment