Amendment Package to Senate Health Care Reform Bill Will Help Rein in Runaway Health Care Costs, Accelerate Shift to Value Over Volume
Michael Bennet, U.S. Senator for Colorado, and a group of his freshmen Democratic colleagues today unveiled a package of amendments to the Patient Protection and Affordable Care Act aimed at increasing transparency, boosting innovation and reining in runaway costs as part of health care reform.
The amendments have been endorsed by many of the nation's leading business, consumer and health provider organizations, including the Main Street Alliance - a coalition of small business owners from Colorado and across the country.
As part of the freshmen package, Bennet authored a provision that streamlines administrative processes so that doctors and nurses can spend less time on paperwork and more time on their patients. Specifically, the provision would require the Secretary of Health and Human Services (HHS) to adopt and regularly update a single, national standard for some of the most basic electronic transactions that occur between insurers and providers.
"Doctors and nurses across Colorado have told me that endless paperwork, confusing codes for claims and a tangled bureaucracy create an overwhelming burden that results in higher-cost and lower-quality care," said Bennet. "We need to bring our system of coding and information sharing into the 21st century. If we do this, we will cut down on red tape, increase transparency and speed innovation that controls costs and improves the quality of care for all Coloradans."
More broadly, the package of amendments offered by Bennet and the group of freshmen Democrats 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.
"Health care reform must make the system more efficient and affordable for Coloradans, and while the bill we're considering is a good step in the right direction, the amendments we're offering today will help move us even closer to that very important goal," Bennet said.
A summary of the specific amendments follows:
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: Gives 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: Broadens 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: Requires 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: Requires HHS to develop standards that will allow efficient electronic exchange and streamlining of information among patients, providers and insurers.
- Health Care Fraud Enforcement: Directs 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: Requires Medicare to implement pay-for-performance for more providers sooner, adding hospices, ambulatory surgical centers, psychiatric hospitals and others.
- Broader Payment Innovation: Allows a broader, more flexible transition to new payment models for Accountable Care Organizations (ACO).
- Medicare System Upgrades: Requires HHS to modernize data systems so that valuable Medicare data can be shared in a reliable, complete, and timely manner.
- Good Quality Everywhere: Promotes 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.