WASHINGTON — Just days before health care reform was scheduled to come up for a final vote, a group of representatives including Betty McCollum and Tim Walz met with House Speaker Nancy Pelosi to hammer out a deal on Medicare reimbursement rates in an effort to add a quality of care to Medicare reimbursement rates.

The deal wasn't for a set rate structure, or quality measurement metric, but rather that one would be set up. It's a regulatory process expected to take years and bring possibly even more lobbying attention (and money) than the health care bill itself.

So with an eye on that, McCollum and three other House Democrats from so-called high-quality/low-cost states formed the Quality Care Coalition. The group aims to provide "a forum to transform the health care system to reward value in care and make evidence-based, quality care the standard regardless of location in the United States."

In other words, quit paying medical providers in Florida and Texas sometimes double what the Mayo Clinic in Rochester gets for the same procedures, despite Mayo having superior results.

Step one in that process comes later this year, when Health and Human Services Secretary Kathleen Sebelius holds the first National Summit on Geographic Variation, Cost, Access, and Value in Health Care. There, regulators will hear ideas on reducing geographic inequities that could become the backbone of the rules that will eventually govern Medicare rates.