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Congressional Testimony



Sebelius Pledges to Work for Long-term

Medicare Payment Solution if Confirmed as

HHS Secretary

By James Arvantes • Washington 4/8/2009



Kansas Gov. Kathleen Sebelius told a Senate committee last week that if confirmed as secretary

of HHS, she would work to change Medicare's payment policies to increase the number of

primary care physicians. She also vowed to work with Congress to find a long-term solution to

problems associated with use of the sustainable growth rate, or SGR, formula, which is used to

determine Medicare physician payment rates.









HHS Secretary-designate Kathleen Sebelius greets Sen. Ted Kennedy, D-Mass., before a hearing

of the Senate Committee on Health, Education, Labor and Pensions. Kennedy is chair of the

committee.

Sebelius, who testified before the Senate Health, Education, Labor and Pensions, or HELP,

Committee, here on March 31 as part of her confirmation process, called for "refocusing the

payment incentives so that primary care becomes a much more lucrative profession." There are

relatively few health care professionals in preventive medicine compared with the number of

subspecialists, said Sebelius, adding "if we focus on prevention and wellness, we will not need as

many (sub)specialists."



Sebelius also called for "growing the market of primary care and family doctors" to place a

greater emphasis on prevention, wellness and early intervention. Part of this process entails

changes in the Medicare payment system and changes in graduate medical education, said

Sebelius, a former state senator and Kansas insurance commissioner.



During the HELP Committee hearing, Sen. Patty Murray, D-Wash., asked about the SGR,

assailing it as an outdated formula that relies on use of services rather than on health care

outcomes to determine payments.



"If I am confirmed as secretary, that will be a top priority -- to work with those of you in

Congress to address a long-term solution," said Sebelius. "I do believe as part of health reform,

Medicare can lead by example, and part of the leadership will require a reconfiguration of the

overall payment system. SGR is a part of it, but only a piece of it."



One of the overarching goals, said Sebelius, is to redirect payments to reward appropriate care,

quality health care outcomes and preventive care. "We have a huge opportunity with the

Medicare system to not only redesign and address the SGR itself, but also to redesign a whole

payment system that redirects care to our senior population and our disabled population," she

said.



If confirmed as HHS secretary, Sebelius will oversee CMS, the CDC, NIH, the FDA and other

agencies that account for nearly $80 billion in annual discretionary spending and hundreds of

billions more in entitlement programs.



Sebelius represents the administration's second attempt to fill the position of HHS secretary. The

administration's first choice for the position, former Sen. Thomas Daschle, D-S.D., withdrew

from consideration after it was reported he had paid $140,000 in back taxes. Although Sebelius

and her husband recently paid $7,040 in back taxes and $878 in interest, that is not expected to

derail her nomination, according to sources interviewed by AAFP News Now.



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