Major Health Care Reform on Tap for 2009
WASHINGTON–On Thursday, Sen. Edward Kennedy, D-Mass., chairman of the Health, Education, Labor and Pensions Committee, strategized from his home with Democratic committee members in a videoconference about sweeping legislation in 2009 to overhaul the U.S. health care system.
The Senate HELP committee will have a big role in any health care overhaul effort, and though he has been diagnosed with brain cancer, Kennedy has told colleagues he expects to return to the chamber in January to lead the effort.
On Tuesday, the Senate Finance Committee–which oversees Medicare and Medicaid in that chamber–held its own hearing as part of a series on health care reform, with this one focused on better coordination of patient care.
Witnesses told the committee that integrated delivery systems could help cut health care costs and improve quality, but that Medicare and private payers are slowing integration because they don’t reward the efficient delivery of care.
In hearing testimony, Robert A. Berenson, senior fellow at the Urban Institute, told committee members that the present health care payment system pits providers against each other and prevents them from working together to deliver better quality care.
And in his testimony, Medicare Payment Advisory Commission (MedPAC) Executive Director Mark E. Miller said, “The health care delivery system we see today is not a true system: care coordination is rare, specialist care is favored over primary care, quality of care is often poor and costs are high and increasing at an unsustainable rate …
“Providers need to increase care coordination and be jointly accountable for quality and resource use. The objective is a delivery system that is focused on the beneficiary, improves quality and controls spending,” Miller said.
He went on to note that the fee-for-service payment system is not designed to reward higher quality and in some cases rewards providers “who increase the volume of services they provide regardless of the benefit of the service.” This, Miller said, leads to high costs for care including avoidable hospital readmissions, lack of coordinated care and follow-up and unnecessary tests and procedures.
“The process of reform should begin as soon as possible–reform will take many years, and Medicare’s financial sustainability is deteriorating,” Miller concluded.
Witnesses also noted medical homes could be a way to integrate care, but that the concept should be thoroughly tested to make sure it works. Incorporating electronic medical records into a medical home system would be critical to its success, they said.
“At the Finance Committee, we’ve had our noses to the grindstone on health reform all year, and I intend to keep a strong focus on reform issues as Congress returns to Washington this fall,” Committee Chairman Max Baucus, D-Mont., said in a statement. “The crisis in America’s health care system is growing and Americans are ready for reform. The climate will be right for change next year.”
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