Delivery System Reforms
Coalition members are deeply concerned about the paucity of delivery system reform language in many of the current legislative proposals and urges that alternatives to fee for service (FFS) be adopted to offer stronger incentives to align payment to quality, reward providers and hospitals that are doing what’s right for patients, and making health care more efficient and less costly. Support for adoption of these alternatives assumes that patient protections and quality assurance mechanisms are in place to meaningfully protect patient care.
Certain forms of bundling and other delivery reforms—if appropriately formulated—seem likely to fit well into the evolving policy framework. Expedited adoption of such reforms many of which are now being tested in demonstration and pilot programs—provided they are designed in a way that reflects the interests of patients, consumers, and providers—could also be linked to a short-term savings trigger. However, a more cautious approach should be taken with bundling demonstrations and pilots of post acute care services for people with disabilities and chronic conditions to ensure that they receive medically necessary services at the appropriate level of intensity. It should be noted that a number of Coalition members strongly encourage permanent repeal of the Sustainable Growth Rate (SGR) provisions and new legislation to better address the quality and value delivery issues. SGR presents too many problems as formulated and presents too great a risk of misapplication and inequitable cuts while failing to recognize quality.
From Rx for Reform
The National Coalition on Health Care's recommendations, based upon the consensus view of 85 member organizations, to make the system less complex, reduce overly high prices, and create a truly competitive health care marketplace. The goal of the paper is to augment the NCHC Principles and Specifications with a more detailed and selective set of policy recommendations on cost containment and quality improvement.
From Facts & Research
Health Reform GPS, a joint project of the Robert Wood Johnson Foundation and the George Washington University Department of Health Policy, has posted an overview of the Medicare Prescription Drug Discount and Rebate Program, as well as a description of the aid made available to low-income Medicare beneficiaries by the Affordable Care Act (ACA). The overview provides some background on the Medicare Prescription Drug benefit, the changes that were made by ACA, and the plan for implementing these reform benefits.
Click here to read the Medicare Prescription Drug benefit overview.
Click here to read an LA Times article regarding when seniors may expect to receive rebate checks as part of the reform benefit.
The Congressional Research Service released an updated report on the potential impact of health reform on the Medicare program. According to their report, CRS finds that at least several provision of health reform legislation intend to improve the program’s overall efficiency and quality through modifications to the payment and provider reimbursement systems, as well as the delivery of care protocols. To read the full report, click here.
According to the Congressional Budget Office (CBO), in a preliminary cost estimate released today, the revised Health Care Reform bill -- H.R. 4872, the Reconciliation Act of 2010 -- would cost $940 billion over 10 years and cut the federal deficit over the next two decades. If enacted it will reduce the deficit by about $130 billion in the first 10 years and by $1.2 trillion over the second 10 years. Reform also will expand coverage to 95 percent of Americans, according to the CBO figures. To read the full CBO report, click here.
Less than one-third of those who received free drug samples have low incomes.
National Coalition on Health Care
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