Rep. Inslee Negotiates Key Agreement On Geographical Disparity And Medicare Reimbursement Rates

Press Release

This afternoon, Rep. Jay Inslee (D-WA), a lead negotiator of the Quality Care Coalition, announced an agreement to address two key issues in health care reform; the significant geographical disparity in Medicare reimbursement that penalizes efficient high quality providers and moving our Medicare payment system from one that reimburses for quantity of care to one that reimburses for quality. The agreement, finally reached at 3:00 AM this morning, will include changes in the reconciliation bill to provide additional monies for efficient providers and hospitals while an additional agreement with the Secretary of Health and Human Services to study and implement changes to the Medicare reimbursement and payment system.

"If you want to cut the deficit, if you want to save Medicare, if you want to grow the economy, and if you want to have quality health care, the status quo isn't good enough," said Inslee. "I encourage everyone to read the bill, as I have, to understand the good this will do for people. After many months of exhaustive work and negotiations I look forward to standing on the floor tomorrow and supporting health care reform."

Washington State is a leader in health care quality and outcomes. Providers and hospitals, like the Everett Clinic and Seattle Children's hospital, are leading the way in health care outcomes and cost efficiency. In a recent demonstration project, the Everett Clinic helped save Medicare $1.6 million in just two years while ranking in the top quality percentiles. And, Seattle Children's hospital, by implementing quality improvement efforts has dropped their appointment wait time by 25%, and seen a 6% annual reduction in per patient costs.

"For decades, Washington State health care providers and hospitals have been reimbursed at far lower rates for providing quality, efficient care, "said Rep. Inslee. "I stood with my colleagues across the country, and worked alongside Rep. Norm Dicks, Rep. Rick Larsen, Rep. Adam Smith, and Rep. Brian Baird, to continue the push for this language to be adopted. With these changes, Washington State will be able to attract the doctors and health care providers our people need."

Members of the Quality Care Coalition were meeting until 3:00 AM Saturday morning hashing out the agreement with the Speaker and the Administration. Along with Rep. Inslee, negotiators included Rep. Bruce Braley, (D-IA), and Betty McCollum (D-MN).

As part of the legislation the House will consider tomorrow, Rep. Inslee and the Quality Care Coalition was able to secure a short-term fix to the Medicare geographic payment inequities by securing $800 million for doctors and hospital until long-term changes can be implement by the Obama Administration.

· $400 million in FY2010 (immediate) for doctor payments under GPCI

· $400 million secured to address geographic disparities for hospitals in the lowest quartile of reimbursement.

Today, Medicare reimburses providers under a fee-for-service system, basing payments to doctors and hospitals on the amount of procedures completed and the number of patients seen. This system creates a financial incentive to order more and more procedures. According to many studies, this increased number of procedures does not result in better outcomes for patients. As part of the agreement, Rep. Inslee and the Quality Care Coalition secured:

· A letter from Sebelius promising the following steps to improve Medicare reimbursement rates for Washington's medical providers:

-Institute of Medicine (IOM) study, beginning in April 2010, to reform the Medicare system to address all geographic disparities for doctors and hospitals and implementation of IOM recommendations by December 2012.

-IOM study, beginning in April 2010, based on house-passed language making firm recommendations to move toward high quality, low cost care across the health care sector and implementation of the recommendations, as part of the new Independent Payment Advisory Board, by 2014.

-Additional direction to the new Center for Medicare and Medicaid Innovation to further test innovative models to incent high quality, low cost care across the provider spectrum.

· A personal commitment from Sebelius to convene a National Summit on Geographic Variation, Cost, Access and Value in Health Care in September of this year.

Source