U.S. Senate Committee Leaders Roll Out Reform Plans, Kick Off Meetings
On Tuesday, Senate Finance Committee Chair Max Baucus (D-Mont.) and ranking member Chuck Grassley (R-Iowa) released a 48-page document outlining their health care reform proposals, the Los Angeles Times reports (Levey, Los Angeles Times, 4/29).
The committee will discuss the proposals Wednesday in the first of three closed-door meetings that will be held over the next several months to write health reform legislation (Budoff Brown, Politico, 4/28).
The proposal aims to:
- Increase the number of primary care physicians;
- Reduce hospital readmission rates;
- Increase transparency;
- Overhaul Medicare Advantage plan payments; and
- Create quality benchmarks for physicians and hospitals.
Under the proposal, primary care physicians who treat Medicare beneficiaries would receive a 5% payment increase, while payments to specialists would be reduced (Edney , CongressDaily, 4/29). General surgeons in rural areas also would be eligible for the 5% bonuses.
In addition, physicians would be penalized for ordering too many high-tech imaging tests (Alonso-Zaldivar/Werner, AP/Richmond Times-Dispatch, 4/29).
Medicare Payment Overhaul
The paper notes that the committee is still looking for a way to permanently fix the Medicare reimbursement formula for physicians.Â Each year, Congress takes action to halt annual payment cuts.
The paper suggests two possible solutions that both include a 1% increase in payments and then a freeze on Medicare physician payments through 2012 (Edney , CongressDaily, 4/29).
The senators also suggest that Medicare reimbursements to hospitals be based on quality-of-care measures for conditions such as:
- Heart attacks;
- Heart failure;
- Pneumonia; and
- Surgical care.Â
Hospitals that meet or exceed quality standards would receive bonus payments (AP/Richmond Times-Dispatch, 4/29).
In addition, they suggest withholding up to 20% of reimbursements to hospitals that have high readmission rates of patients with chronic conditions.
According to the proposal, MA plans should be required to bid competitively to reduce payments, or plan payments should be cut by either basing them on a combination of federal and local Medicare spending, or a mix of across-the-board reductions or decreases in the highest spending areas (Edney , CongressDaily, 4/29).
Another proposal included in the document is the establishment of an independent institute governed by a "multi-stakeholder board" to conduct comparative effectiveness research for medical treatments and procedures.Â The proposed institute would be funded in part by a tax on private insurance companies.
According to the document, the research institute should be "prohibited from issuing medical practice recommendations or from making reimbursement or coverage decisions or recommendations" (Politico, 4/28).
What's Next?More documents are expected from the committee, which will focus on how to increase health care coverage and how to finance a massive health system overhaul, CQ Today reports (Wayne, CQ Today, 4/28). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.