Cantwell Negotiates Deal to Pay Doctors for Quality Care, Not Quantity of Services
Amendment delivers long-awaited solution to Washington state's Medicare reimbursement disparity
“I am not a member of the ‘Gang of Six’” Cantwell said in today’s Finance Committee mark-up, referring to the bipartisan Senate group that developed the Committee’s original proposal, “but I am a member of the gang of six million Washingtonians.”
The problem, Cantwell said, is that while
For years, a complex formula has paid doctors caring for Medicare patients on a fee-for-service basis. That formula has the unintended effect of punishing
“For too long,
For years, Cantwell has worked to reform Medicare’s fee-for-service model to focus on quality. Most recently, she and Senator Amy Klobuchar (D-MN), who has also been a strong advocate for reforming Medicare’s payment structure, gathered the signatures of 26 bipartisan senators for a letter sent last week to President Barack Obama urging reform of the Medicare system.
“The change included today will help control costs and get the most from our healthcare dollars,” said Senator Klobuchar. “This will strenghten the strong safety net of Medicare by ensuring funds are there to pay for our seniors' health care.”
Currently, Medicare wastes $120 billion a year, or 30 percent of all Medicare spending. This waste is due, in part, to incentives in the Medicare physician payment structure. Cantwell’s amendment provides incentives to doctors to work toward the best outcomes, instead of paying them for ordering more services and spending more money.
Cantwell’s amendment, included in the modified mark released by the Senate Finance Committee today will:
- Uses quality measures that factor in differences in the health of patients (such as age), and specifies that “quality” must be defined based on health outcomes – doctors get evaluated on the results they produce for patients. This puts the focus on the patient.
- Aims to improve coordination and efficiency within the health care delivery system. It would be used to coordinate other value-based proposals, not compete with them.
- Sets out a clear timeline for reform, while still providing the flexibility to incorporate new research. It maintains a focus on the policy changes we know produce results: all providers must have incentives to produce good patient outcomes in a way that is fair and effective.
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