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Public Statements

Health Care

Floor Speech

Location: Washington, DC


Ms. BALDWIN. Mr. President, I thank my colleague for convening us and for giving us an opportunity to discuss the important topic of delivery system reform and to highlight some of the innovations that are occurring in our own States.

I heard Senator Whitehouse talking about moving forward. It is actually the motto of the State of Wisconsin. One simple word: ``Forward.'' Throughout our State's history, that motto has well represented our leadership in extending high-quality and affordable health care.

Our health care providers and payers have pioneered forward-looking reforms that improve the quality of care and lower costs for families and for businesses. We are home to world-class, highly integrated health care systems. We make quality and outcomes data widely accessible to providers so they can measure their success against their peers. We stand at the forefront of using and advancing health care information technology. All of this affords some of the highest quality care in the country at a competitive cost.

Congress has a lot to learn from Wisconsin's health care delivery systems. A recent Institute of Medicine report reinforced what we have known for a long time: that geographic variation in health care spending and utilization is real and that variations in health care spending are not consistently related to health care quality. For every State such as Wisconsin with higher quality outcomes and lower costs, there are five other States faring worse. Even within States, the regional variation in health care spending and quality is troublesome.

Unfortunately, instead of advancing and fostering forward-thinking innovations such as those working in Wisconsin, far too many of my fellow lawmakers are looking backward when it comes to health care. In the House of Representatives, the Republican leadership has scheduled votes to repeal or defund the Affordable Care Act almost 40 times. Some State governments--including, unfortunately, my own--have refused to move forward with America's new health care law and are undermining its effectiveness at every chance possible. Now some of my colleagues in the Senate are threatening to shut down the government if investments in our health care system are not stripped out of our budget entirely.

Families and businesses in Wisconsin and across the country are tired of these political games. For as long as some of my colleagues and some of the Governors across this country remain glued to the past, waging political fights based on pure ideology, we lose golden opportunities to move health care reforms in our country forward. We should all be focused on building a smarter and more affordable health care system, not trying to tear down the law of the land.

That is why I am so proud to stand on the floor with my colleagues tonight, committed to moving our Nation's health care system forward. By building on the best reforms to our health care delivery system that are embedded within the Affordable Care Act and making new improvements to how we deliver care in our country, we will lower health care costs, improve quality and strengthen our economic security and reduce the deficit. Better yet, we will have more States with health care systems such as Wisconsin's, and Wisconsin's system will be improved as well.

The possibilities are exciting. I think one of the things Senator Whitehouse just mentioned bears repeating: There is widespread agreement that significant savings can be achieved in our health care system without compromising the quality of care. The figures he cited bear repeating: The Lewin Group and the former Treasury Secretary Paul O'Neill have estimated that we could save $1 trillion per year without affecting health care outcomes by enacting smart, targeted health care delivery reforms. The New England Health Care Institute pegged that number at $850 billion annually, the Institute of Medicine estimated this number to be $750 billion, and the President's Council of Economic Advisers foresees savings at $700 billion a year. No matter the exact figure, these are impressive savings that would strengthen our entire Nation.

The Affordable Care Act has sparked this hard work of transforming health care delivery. The law provides health care practitioners with incentives to better integrate care, increase quality, and lower costs. These efforts are producing impressive results in Wisconsin. For example, the Pioneer Accountable Care Organization Program has offered financial incentives to meet quality and Medicare savings benchmarks. Bellin-ThedaCare Healthcare Partners in northeast Wisconsin has excelled with this program. In its first year of participation, Bellin-ThedaCare earned $5.3 million in shared savings and lowered costs for its 20,000 Medicare patients by an average of 4.6 percent. While not every pioneer ACO has been as successful, the CMS Office of the Actuary believes this program could save Medicare up to $1.1 billion over 5 years by simply better coordinating care.

Wisconsin boasts six additional health care providers participating in the law's traditional Accountable Care Organization Program which the Department of Health and Human Services estimates could save up to $940 million over 4 years. Wisconsin health care providers are also taking part in the Affordable Care Act's Partnership for Patients to improve health care quality. This public-private partnership engages hospitals, businesses, and consumer groups with the goal of preventing injuries and complications in patient care--including hospital-acquired conditions.

The administration estimates that reducing medical errors and preventing conditions will save up to $35 billion in health care costs.

Another public-private partnership--the Affordable Care Act's Million Hearts Initiative--is preventing heart attack and stroke. Cardiovascular disease costs this country $440 billion per year in medical costs and lost productivity. The initiative seeks to deliver better preventive care to stop 1 million strokes and heart attacks by the year 2017--in part by utilizing innovative technology. Wisconsin's own Marshfield Clinic designed a winning mobile application for the initiative. The app will encourage patients to get their blood pressure and cholesterol checked and to work with their health care providers to improve their heart health.

Finally, the Affordable Care Act has empowered the CMS Innovation Center to develop new ideas to improve health care quality and lower costs for people enrolled in Medicare, Medicaid, and the Children's Health Insurance Program. A number of the center's projects are currently underway in Wisconsin. For example, the Children's Hospital of Wisconsin, Aurora HealthCare, and the Wheaton Franciscan Healthcare system have created a model to decrease emergency room visits for children. The estimated 3-year savings of that project is almost $3 million. In addition, the Pharmacy Society of Wisconsin is utilizing a provision in the Affordable Care Act to better integrate pharmacists into clinical care teams. That initiative is set to save over $20 million in 3 years.

This represents a small sampling of the delivery innovations being promoted through the Affordable Care Act that are saving us money right now. These parts of the law are empowering Wisconsin health care providers to provide higher quality care at reduced costs. Public officials who advocate for repealing the Affordable Care Act would end these impressive initiatives as well. Instead, we must build on these delivery reforms, as so much more can be done.

To name two priorities, Wisconsin cardiologists have developed an innovative integrated network called SMARTCare to deliver better more efficient care for a vulnerable patient population. The Department of Health and Human Services should encourage this coordinated care model by investing in it and measuring its results.

We should improve the law to increase access to Medicare claims data. The Wisconsin Health Information Organization currently holds over 65 percent of health insurance claims data in the State--from private insurers and from Medicaid. The organization shares that data with health care providers so doctors can compare their performance--in terms of quality and cost--against their peers. This data-sharing promotes competition and it lowers cost. But due to current law, the organization cannot access Medicare data. If we open Medicare claims data, we will further improve quality and we will lower costs.

Lawmakers have a clear choice: Go backward and try for the 40th time to repeal the Affordable Care Act or put progress in our country ahead of politics. We welcome our colleagues to join us in moving our country and our health care delivery system forward.

I now yield for Senator Murphy.


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