In support of health care reform

Document Sample
In support of health care reform Powered By Docstoc
					 Noon Conference:
Health Reform Update
    October 2009
    This is an incredibly busy and
            important time
Congress has been mainly driving this process:
• Senate has 2 committees with jurisdiction
   – Health, Education, Labor, Pension (HELP) and
     Finance each committee working on their own bill
• House has 3 committees with jurisdiction
   – Ways and Means, Education and Labor, Energy and
     Commerce the three committees have been
     working together to come out with one bill
President Obama has strongly supported the process:
• Health Care Forum at the White House in March to bring
  together all stakeholders
• White House Health ―Czar‖: Nancy Anne DeParle
   The latest from Capitol Hill
• Both the HELP committee and the Finance
  Committee have completed their bills and
  successfully voted them out of committee
  for a full Senate vote
• Currently the bills are being merged into
  one consolidated bill which should be
  released soon.
    The latest from Capitol Hill
• All three committees have voted on HR
  3200 ―America’s Affordable Health
  Choices Act”
• The Congressional Budget Office ―scored‖
  the bills and they are fully paid for over ten
• The bill is due for a floor vote in the House
  in early November
      Why the rush?
Do we need reform this year?
    Is status quo acceptable?
                   Why reform?
High cost
• The cost of health care for the average American family is $16,771
• Half of all bankruptcies are related to medical expenses
Americans lack Access to Care:
• 14,000 Americans lose health insurance coverage everyday
Doctors are working within a broken system
• Spending more time filling out papers than with their patients
• Doctors are undervalued- especially in primary care fields
• Doctors work with the threat of mal practice suits
• The payment system rewards the number of procedures rather than
   the quality of care provided
  The type of reform doctors want:
• We want health reform that promotes:
  – Accessibility
  – Affordability
  – Quality
• Keep what works
• Fix what’s broken

• How does this play out in the current
  health reform legislation…..
The Proposed Health Reform
 What’s in it for doctors and their
 Increased Choice: makes sure people can
   choose coverage that fits their needs
A Health Insurance Exchange
   • Small businesses and individuals who qualify can enter the
     health insurance exchange and choose from a range of private
     and public health insurance options.
A public health insurance option
   • A government run insurance company that can be on option
     among many for patients
Guaranteed coverage and insurance market reforms
   • limits the ability of insurance companies to charge higher rates
     due to health status, gender, or other factors.
Essential benefits package – sets a minimum standard for
  what insurance companies should cover
Increased affordability: makes sure people
       can afford their health care

• Limits out-of-pocket spending for health
  insurance and preventative services
• Includes subsidies for the middle class to
  purchase health insurance
• Includes subsidies for small businesses to
  purchase health insurance for their employees
• Eliminates co-payments for preventive services
• Expands pharmacy benefits in Medicare to close
  the ―doughnut hole‖
Increased access: makes sure people have
      access to a primary care doctor

• Enhances the primary care workforce
  – 5% increase in payments to primary care
    providers under Medicare and Medicaid.
  – Provides loan forgiveness for primary care
    physicians who practice in underserved areas
• Increases funding for the National Health
  Service Corp
• Expands Community Health Centers
Improvements to Medicare: makes Medicare
       more efficient and effective
• SGR Reform:
   – House – complete reform of SGR ($245 billion
     expense to fix physician payment –20% of the cost of
   – Senate: band-aid for 1 year
• Creates pilot for innovative delivery system models such
  as accountable care organizations, medical homes, and
  bundling of acute and post-acute provider payments.
• Creates new payment incentives to decrease
  preventable hospital readmissions.
• Creates new methods for administrative simplification.
Improved quality: helps doctors take better, more
   consistent, more effective care of patients

• Invests in comparative effectiveness research
• Creates pilots for innovative delivery system
  models: medical home and accountable care
• Creates community-based programs to deliver
  prevention and wellness services
• Invests in efforts to better identify and address
  health disparities along racial, ethnic, and
  regional lines
           In Summary:
Health care reform working for you...
1.   Increase choice
2.   Increase affordability
3.   Increase access
4.   Improves Medicare
5.   Improves quality
Public Plan Options being considered by
              the House:
1. Linking to Medicare Payment Rates: In the most robust, the
   public plan would pay hospitals and other providers based on
   Medicare reimbursement rates, typically lower than private
   insurance rates. That would allow the public plan to charge lower
   premiums than private plans, and save the government substantial
   money in reduced subsidies — more than $100 billion over the next
   decade. There is a danger that the low payments might push some
   hospitals, especially in rural areas, into deeper financial trouble.

2. Negotiated reimbursement rates with providers: the plans
   bargaining power would depend on how many people it enrolled.

3. Hybrid version: start with negotiations with providers to set prices
   for services, but switch to a Medicare-based formulation if the plan’s
   premiums rose too rapidly with care taken to mitigate adverse
   effects on rural areas.
       Medical Liability Reform
• Amendment in the House bill that authorizes
  state pilot programs for medical liability reforms
• As we invest in quality and safety in the health
  care system –this will foster a safer practice
  environment for physicians and safer care
  environment for patients.
   – Quality improvement initiatives through Medicare
   – Improved care coordination
   – Large investment in HIT that will drive decision
     support tools
   – Evidence based medicine will help physicians make
     sound decision about treatment options
      The hurdles still to come
• The full House must vote on and pass their bill
• The Senate must merge the HELP and Finance
  bills….and then the full Senate must vote on that
• Once both the House and Senate have passed
  bills of their own – they must ―conference‖ to
  merge the two versions of the bill into one final
• Then that final version must be passed again by
  the House and Senate
        Thank you for support.
                  For more information, visit:

   Doctors for America is a grassroots group of over 15,000
 physicians in all fifty states committed to passing meaningful
health reform legislation. The group works to convey the ideas
 and experiences of physicians in order to achieve reform that
 provides high quality, affordable healthcare for all Americans.