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HCFA Reacts to Senate Payment Reform Bill

HCFA Reacts to Senate Payment Reform Bill

May 10, 2012

Yesterday afternoon the Senate released its payment reform proposal. Like the House bill, the Senate bill (full text) advances the discussion on how to make systemic changes to our health care delivery system. We're busy tearing through the 5080 lines of legislative text, and will be working with Senators on a number of amendments. Debate will be next Tuesday, May 15. But our first reactions are here:

Statement from Health Care For All's Executive Director Amy Whitcomb Slemmer regarding the Senate bill S. 2260, an Act Improving the Quality of Health Care and Reducing Costs Through Increased Transparency, Efficiency and Innovation:

"We are pleased that the Senate has proposed an approach to improving health care quality and patient care while reducing the cost of the care we receive. We appreciate the hard work of Senate President Therese Murray to ensure that these provisions are meaningful for consumers.

This legislation makes great strides towards improving the coordination of care and access to preventive and primary care services. We are particularly encouraged by the bill's approach to incorporating behavioral health services with those that are traditionally provided for physical health. We know that the two are inextricably linked, and believe that this era of health reform provides the much needed opportunity to remove barriers to behavioral health treatment and care.

Health Care For All applauds the Senate's commitment to increased transparency, as we believe this is an important building block for patient empowerment. We also are pleased by the description of enhanced consumer protections in the event of medical errors.

We are grateful that the Senate included the creation of and robust funding for the Prevention and Wellness Trust Fund. We know this investment in wellness and preventable chronic diseases such as obesity, diabetes and asthma, when done from the community level, can simultaneously keep patients healthy while lowering overall health care costs.

We support the integration of behavioral health into the overall health system through the establishment of behavioral health medical homes and the vigorous implementation of the federal Mental Health Parity and Addiction Equity Act. Together these laws will make a significant difference to people who need these services.

HCFA will look closely at the details of this comprehensive bill and looks forward to working with the Senate to make sure that the needs of consumers are represented in both the spirit of the legislation and the implementation of the resulting law."

Senate Bill Promotes Patient Safety and Quality

The Senate’s payment reform bill released yesterday has some important provisions that seek to improve health care quality and patient safety. The bill requires the Department of Public Health to develop model checklists of care that may be used by hospitals to prevent medical errors and infections. Hospitals are required to report to DPH and the Betsy Lehman Center on their use or non-use of checklists. The one thing we would like to see changed is the section requiring that individual hospital reports be kept confidential and that DPH issue a public report on aggregate rates of checklist use. Publicly reporting aggregate rates, while giving us a sense of the direction the state is moving in as a whole, is pretty meaningless to consumers who want to find out if a particular hospital is focused on patient safety. Checklists are proven tools and should be used by every hospital. We would like to see the public report look at each individual hospital.

The bill also requires Beacon ACO’s to promote patient-centered care by, among other things, demonstrating that they engage patients in shared decision making, they effectively involve patients in care transitions across settings of care, and they activate patients at home to improve care self-management, and by establishing ways to evaluate patient satisfaction with access and quality of care. Beacon ACO’s are also required to show excellence in the area of care coordination and show a commitment to reducing avoidable hospitalizations and adverse events. These are all HCFA priorities and we are pleased to see them addressed in the bill.

The Senate bill also creates a task force to look at the practice of defensive medicine and overuse of medical care, including the overuse of imaging and screening technologies. At least one member of the task force must be a health care consumer representative. Along with checklists, HCFA and the Consumer Council have been advocating for legislation to look at overuse of technologies and we appreciate its inclusion in the bill.

Finally, the bill also creates a Massachusetts Diagnostic Accuracy Task Force, which will include consumer representatives, to make recommendations on how to reduce or eliminate the impact, both financially and in terms of patients’ health and well-being, of inaccurate diagnoses.