Quality Data, Medicare+Choice to Be Part of HCFA Overhaul Plan

As part of an effort to "overhaul" HCFA, agency officials plan to issue "detailed ratings of the quality of care" given to Medicare beneficiaries and to increase enrollment in Medicare+Choice, the Washington Post reports. In his first speech as head of HCFA, Thomas Scully told the U.S. Chamber of Commerce that HCFA intends to issue ratings of nursing homes, Medicare health plans, dialysis centers and "eventually hospitals and doctors" through newspaper advertisements, the Internet and toll-free telephone numbers. The ratings would be based on "a half-dozen criteria, ranging from medical credentials to staffing levels" and would be released four times per year. The ratings, which would include government inspection reports and consumer surveys, would "provide the most comprehensive, objective way to evaluate health care providers, going far beyond the limited information currently available to consumers," the Post reports. The federal government now collects information on thousands of Medicare providers, but has never presented the data in "an easy-to-understand way," the Post adds. HCFA is still working out the plan's details, but staff members said the agency has "the data, money and authority to move quickly."

The ratings plan has "far-reaching -- and controversial -- implications for millions of Americans," the Post reports. Proponents of the plan said it will give consumers a way to "aggressively shop for health care." And ratings seem to be the best way to "force the health care industry to raise its standards," the Post reports. But industry representatives cautioned that the data could be "misleading" if it does not consider various factors, such as whether care facilities treat sicker patient populations (Connolly, Washington Post, 6/5).

Another component of HCFA's revamping would aim to have 30% of Medicare beneficiaries -- twice the current amount -- in HMOs by 2005, Scully said. Such a plan "signal[s] a big change," the New York Times reports, noting that in the past several years, many HMOs have withdrawn from Medicare in various areas, citing "inadequate" payments and "excessive" regulations. Scully said he has met with insurance officials to convince them to remain in Medicare+Choice, but did not say whether he would support increasing Medicare payments to HMOs. Karen Ignagni, president of the American Association of Health Plans, said, "The administration appears to be truly committed to expanding choices and preserving options for beneficiaries." But Rep. Pete Stark (D-Calif.) said that the administration appears to be "rewarding friends on Wall Street who had invested in managed care." John Rother, director of legislation and public policy for AARP, added that doubling Medicare+Choice enrollment "would not be easy" (Pear, New York Times, 6/5).

Scully also said yesterday that changing HCFA's name will be necessary to "reflect a new way of doing business," adding that one possible name would be the "Medicare and Medicaid Administration," or MMA. He added that the agency will "most likely not" be called MAMA, a possible acronym "floated" by HHS Secretary Tommy Thompson earlier this year. Scully sent letters to HCFA employees last week soliciting name suggestions (Fulton, CongressDaily/AM, 6/5).