WASHINGTON, D.C. -- Sen. Amy Klobuchar introduced Medicare reform legislation on the Senate floor today, stepping into the midst of the building health-care debate as an advocate for Medicare payment reform that rewards outcomes over number of tests.

“So, to my colleagues that are conjuring up reasons not to pass reform this [year], using scare tactics about nationalized health care and engaging in fear mongering, I would say we can’t stay where we are,” said Klobuchar, pointing to the rising cost of health care for individuals and the federal government. “We can’t stay where we are. They must be getting different mail than I am... They [my constituents] are not saying, ‘Let’s stay the way we are.’ They are saying, ‘Let’s reform the system.’”

The Democrat did not specifically address other portions of the developing health-care reform legislation, including the controversial public health insurance plan option, which could be run by the government alongside existing private insurers, or the relatively new co-operative proposals, which could include the possibility of a national co-operative, owned and operated by its members.

Instead, Klobuchar focused on fixing the current Medicare system, which favors states that spend more on health care, regardless of the quality of care. This puts states with relatively low health-care costs, like Minnesota, at a disadvantage when it comes to Medicare funding, according to Klobuchar.

“We need to be sure to keep score,” Klobuchar said. “That means measuring outcomes and rewarding providers that deliver quality results.”

The Medicare Payment Improvement Act would create a value index for determining Medicare physician fees. The value would be calculated by a quality component, which would be determined by the secretary of Health and Human Services, divided by efficiency, which would be measured as total Medicare spending per beneficiary in the area. The legislation would also seek to link rewards to outcomes and reinforce coordinated health-care systems within communities.