In Support of Cost Control

This morning, eleven freshman Senators introduced a series of health care reform amendments which they call the Value and Innovation Package (thanks New Health Dialogue for pointing this out). These amendments would be designed to strengthen the cost control measures in the current bill, with an eye toward bending the health care cost curve. Among the more promising amendments include:

• Pilot Testing Pay-for-Performance Program for Certain Medicare Providers. Directing the Secretary to begin pilot testing of value-based purchasing (pay-for-performance) programs for certain types of Medicare no later than January 1, 2016. These provider types include: inpatient psychiatric hospitals, long-term care hospitals, inpatient rehab facilities, acute prospective payment system-exempt cancer hospitals, and hospices. The Secretary would have authority, after 2018, to expand these pilots if the CMS Chief Actuary determines it would reduce Medicare program spending while maintaining or improving the quality of care.

• Revisions to National Pilot Program on Payment Bundling. Modifying the new CMS pilot on Medicare bundled payments created by the Patient Protection and Affordable Care Act. It would expand the number of health conditions tested under the pilot and give the Secretary authority to expand the duration or scope of the pilot after January 1, 2016 if the CMS Chief Actuary determines it would reduce Medicare program spending while maintaining or improving the quality of care.

• Improvements to the Medicare Shared Savings Program. Giving the Secretary greater flexibility in administering the Medicare Shared Savings Program. This program is created by the PPACA to reward Accountable Care Organizations (ACO) that successfully coordinate care to lower costs and improve the quality of care.

• Additional Improvements Under the Center for Medicare and Medicaid Innovation. Granting CMI additional flexibility in selecting models to be tested and permits the Secretary to give preference to models that would align Medicare and Medicaid spending with other public sector or private sector payer quality improvement efforts.

• Expansion of the Scope of the Independent Medicare Advisory Board. Requiring the Independent Medicare Advisory Board (IMAB) created under this Act to produce an annual report starting in 2014 that includes national and regional information on the cost, utilization, quality, and other features of health care paid for by private payers. IMAB also would be required to take the findings of these reports into account when preparing proposals to improve Medicare. IMAB also would, starting in 2015 and at least every two years after, submit recommendations to Congress and others on how to slow the growth in national health expenditures.

We hope to see more amendments like these, so that health reform really can be a means to slowing cost growth.