WASHINGTON WIRE
November 16, 2009
Issue 222
Healthcare Reform Debate likely to Continue through the End of Session
House Could Take Up Physician Payment Bill This Week
NEJM Report Finds Expanded Bundling Could Reduce Health Care Spending
NQF Releases Standard Definitions for Gathering Quality Information Using EHRs
Top Story
Healthcare Reform Debate likely to Continue through the End of Session
Democratic Senate leadership continues to work on bringing healthcare reform legislation to the floor for debate and votes, but it appears likely that any final vote will be delayed by lengthy debate. The Congressional Budget Office has yet to release a final score on the merged bill, which is an amalgamation of provisions from the Senate Finance and HELP Committees versions.
Senate Majority Leader Harry Reid (D-NV) could release legislative language and move the legislation to the floor before Thanksgiving. But it is unlikely the bill will be brought to the floor before a final score is complete.
The cost of the legislation to overhaul the healthcare system, and the inclusion of a number of controversial provisions in the bill, could make it difficult for moderate Democrats to vote for passage. President Obama has set a target of $900 billion for the cost of the legislation. Reid has indicated that the final bill will include a form of the public option that will allow states to opt out by 2014.
Health Care News
House Could Take Up Physician Payment Bill This Week
The House of Representatives is expected to take up legislation this week that would provide a permanent fix to the physician fee problem and avoid over a 20 percent cut in fees set to go into effect next year. On November 7, the House of Representatives approved a rule for the debate on the bill (HR 3961) alongside legislation to reform the healthcare system. The physician fee fix was originally included in the overall healthcare reform legislation, but was separated from the larger bill in part due to cost concerns. The CBO scored the Medicare Physician Payment Reform Act of 2009 at $210 billion over 10 years.
H.R. 3961 would alter the sustainable growth rate formula used to calculate physician reimbursement under Medicare. The bill would provide a 2010 payment update of 1.2 percent. In 2011, the legislation would create separate target growth rates and conversion factor updates for two categories of service: evaluation, management, and preventive services, and all other services.
The bill omits pay-fors, but is likely to be coupled with a reinstatement of the pay-as-you-go budget law. Last month, the Senate failed to begin debate on a similar bill that would alter the physician payment system and avoid the pending slash to payments. The Senate Finance version of the overhaul healthcare reform bill postpones the cut and provides a payment update for 2010.
NEJM Report Finds Expanded Bundling Could Reduce Health Care Spending
A report published in the New England Journal of Medicine November 11 found that bundling payments from private and public payers could reduce national health care spending by over 5 percent over a decade. Under a bundled payment approach, the payer provides a single payment for all health care services related to a certain treatment or condition. The researchers looked at 12 policy options to reduce healthcare spending, and bundling was the option they found would produce the most savings over the 10 year period.
The Congressional Budget Office estimated that bundled payment provisions would save .05 percent over the same decade. The CBO focused only on Medicare hospital and post-acute care services. The NEJM article, entitled "Controlling U.S. Health Care Spending - Separating Promising from Unpromising Approaches" - looked at bundled payments for chronic and acute conditions in the Medicare and private payer system.
NQF Releases Standard Definitions for Gathering Quality Information Using EHRs
Last week, the National Quality Forum released a standard set of definitions for collecting quality data using electronic health records. The Agency for Healthcare Research and Quality contracted with NQF to develop the standard definitions. The NQF had found that the lack of standard quality measures impeded the comparison of quality using electronic health information. The NQF developed the Quality Data Set to provide a common framework for defining clinical data to measure quality of care performance.
Upcoming Events
Hearings
Tuesday, November 17
H1N1 Flu Vaccine Availability
Senate Homeland Security and Governmental Affairs Committee
2:30 p.m., 342 Dirksen Bldg.
Wednesday, November 18
Food Safety Act; Labor, HHS Nominations
Senate Health, Education, Labor and Pensions Committee
10 a.m., 430 Dirksen Bldg.
H1N1 Preparedness
House Energy and Commerce - Subcommittee on Health
10 a.m., 2123 Rayburn Bldg.
Thursday, November 19
Disability Claims Backlog
House Ways and Means - Subcommittee on Social Security
1:30 p.m., B-318 Rayburn Bldg.
Cancer Research
House Energy and Commerce - Subcommittee on Health
2 p.m., 2322 Rayburn Bldg.
For More Information
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