WASHINGTON, D.C. — Despite the heated rhetoric surrounding health-care reform here, there may be some common ground that advocates say could mean far more money for Minnesota health care providers.
Some form of the same proposal is included in the Senate’s health-care bill, the House’s bill and two separate scaled-down framework proposals, one led by President Obama and the other by Blue Dog Democrats like Rep. Collin Peterson.
That issue of agreement is including a quality-of-care metric as part of the Medicare reimbursement rate formula, an issue long championed by some medical centers like the Mayo Clinic in Rochester, Minn. Though the House and Senate versions differ, and neither Peterson nor Obama have offered specifics of how their plan would work, advocates see the correlation as a sign that, despite the fractious debate in Washington, some quality-of-care metric may yet become law this year.
The current Medicare formula doesn’t consider patient outcomes, and as a result some hospitals in Texas and south Florida can get paid double what Mayo does for performing the same procedure, even though their patients don’t have the same success rates.
“If we want better outcomes, better safety, better service and lower costs, we should align our payment system so we do that,” said Jeff Korsmo, executive director of the Mayo Clinic Health Policy Center.
Quality-of-care, also known as pay-for-value, has been the top priority for most Minnesota lawmakers during the health care debate this session — and something everyone seems to agree on. Back in July, Minnesota’s entire congressional delegation signed on to a letter encouraging the Obama administration to include quality-of-care in any health care bill.
“All Americans pay equally into Medicare, yet beneficiaries in Minnesota are severely disadvantaged in the essential benefits they receive when compared to citizens in other states, such as Florida, New York, or California. Why are Minnesotans paying higher premiums for prescription drugs, dental, vision and hearing services while residents of other states receive those benefits free of any additional cost? This flawed Medicare formula continues to penalize Minnesota taxpayers, patients, providers, hospitals, counties, and the entire health care sector that provides high-quality, low-cost care,” the letter read.
Rep. Tim Walz, a Democrat whose district includes the Mayo’s flagship center in Rochester, said he’s considering proposing pay-for-value as a stand-alone piece of legislation — though he added that opposition from some in states like New York, Florida and Texas who benefit most from the present funding formula may require the provision to be packaged with something else to be able to pass.
“I’m convinced, and Mayo is convinced that you can literally save hundreds of billions a year to be used to insure those who aren’t insured and make sure that you’re changing the way that health care is delivered,” Walz said. “In all actuality, if we passed only four pages of this bill and it was the four sections of this bill [that cover quality-of-care] then we would get real cost containment and reform.”
Here is a recent letter to members of Congress from executives at Mayo offering their views on health care issues.