“The health-reform legislation now being considered by the Senate makes big strides in beginning to fix what is fundamentally broken in our present health care system – but we believe that we can go even further,” Sen. Warner said. “Our amendments encourage a broader, quicker shift toward a more innovative 21st century health-care system. Our goal is a health-care system that is more efficient and affordable for consumers, and one which will hold health care providers and insurers more accountable.”
The 11 freshmen are Sens. Mark Begich (Ala.), Michael Bennet (Colo.), Roland Burris (Ill.), Kay Hagan (N.C.), Ted Kaufman (Del.), Paul Kirk (Mass.), Jeff Merkley (Ore.), Jeanne Shaheen (N.H.), Mark Udall (N.M.), Tom Udall (Colo.) and Warner (Va.).
The package of amendments strengthens the Senate’s current health-reform proposal in three significant ways:
– It establishes public-private arrangements to better synchronize changes across medicine, with an eye towards preventing cost-shifting to others.
– It eliminates red tape and fights fraud, which drives-up costs.
– And it compels Medicare to become a leader in overall health reform by speeding the move toward a higher-value, lower-cost model for the future.
The amendments have been endorsed by many of the nation’s leading business, consumer and health provider organizations, including AARP and The Business Round Table.
The highlights of the legislation:
Working More Closely with the Private Sector on Cost Containment
These amendments transform payment systems and improving quality to require the public and private sectors to move forward together on the shared goals of cost containment, improved quality, and delivery system reform.
· CMS Innovation Center: We give the new Innovation Center explicit authority to work with private plans to align Medicare, Medicaid and private sector strategies for improving care.
· Independent Medicare Advisory Board: We broaden the scope of the new Independent Medicare Advisory Board to look at total health system spending and make nonbinding, system-wide recommendations.
· Quality and Value in Private Insurance: We require the Secretary to consult with relevant stakeholders to develop a methodology for measuring health plan value, which would include the cost, quality of care, efficiency, actuarial value of plans. Developing the tools to assess health plan value will help consumers and employers make better apples-to-apples comparisons when they shop for health insurance and get the best value for their health care dollar.
Stepping-up the Commitment to Reduce Regulatory Barriers and Fight Fraud
These amendments require the U.S. Secretary of Health and Human Services (HHS) to aggressively pursue streamlined regulations and anti-fraud initiatives to ensure that all sectors of the health care system work together to improve value.
· Administrative Simplification: We require HHS to develop standards that will allow efficient electronic exchange and streamlining of information among patients, providers and insurers.
· Health Care Fraud Enforcement: We direct HHS to better utilize technology to prevent health care fraud.
· Eliminating Legal Barriers to Care Improvement: In tandem with this package, the freshman senators will be requesting that the U.S. Government Accountability Office study current laws and regulations to identify barriers to implementing innovative delivery system reforms. We also will request that the U.S. Department of Justice and the Federal Trade Commission work together to provide clearer guidance to providers who wish to enter into innovative collaborative arrangements that promote patient-centered, high quality care.
Aggressively Moving Toward Delivery System Reform
These amendments allow HHS to experiment with promising new models to further lower costs, increase quality and improve patient health.
· Value-Based Purchasing: We require Medicare to implement pay-for-performance for more providers sooner, adding hospices, ambulatory surgical centers, psychiatric hospitals and others.
· Broader Payment Innovation: We allow a broader, more flexible transition to new payment models for Accountable Care Organizations (ACO).
· Medicare System Upgrades: We require HHS to modernize data systems so that valuable Medicare data can be shared in a reliable, complete, and timely manner.
· Good Quality Everywhere: We promote greater access to tele-health services, strengthen the provider workforce and the availability of high-quality hospital services to bolster health care access for Americans in underserved and rural regions.