by Donna Smith
Last Updated: 2009-04-29 13:00:22 -0400 (Reuters Health)
The Medicare health program for the elderly would change the way it pays hospitals and doctors to encourage better quality care at lower cost under proposals unveiled on Tuesday by two senators leading the debate over revamping the U.S. healthcare system.
Senate Finance Committee Chairman Max Baucus, a Democrat, and Senator Charles Grassley, the panel’s top Republican, are also looking at giving primary care doctors and general surgeons bonuses for providing special services to Medicare patients with costly chronic illnesses.
The proposals will be presented to other committee members on Wednesday for discussion as lawmakers begin to flesh out details of a sweeping healthcare overhaul aimed at reining in soaring costs and eliminating the ranks of the uninsured.
"Nothing is set in stone," Baucus said in a statement. The proposals outlined by Baucus and Grassley in a discussion paper focus on changes to the Medicare payment system to promote delivery of better care at lower costs.
The policies are aimed at encouraging better coordination among doctors to reduce duplication and unnecessary procedures while providing a better continuity of care.
To that end, one proposal would allow Medicare to set up pilot programs to test innovative delivery and payment systems to help determine what works best to manage patients with chronic conditions.
Another proposal would encourage greater cooperation by bundling payments to hospitals to cover all costs associated with a particular episode of care for a patient. Hospitals also would receive incentive payments to reduce readmissions.
The current Medicare payment system, based on the number of treatments and procedures, discourages that kind of coordinated care, the discussion paper said.
President Barack Obama has made a sweeping overhaul of the U.S. healthcare system, which he says will help long-term U.S. economic recovery, a top priority. Democrats, who control Congress, hope to deliver a bill to his desk by the end of the year.
The United States has one of the world’s most expensive healthcare systems, yet about 46 million people are without insurance coverage and studies show the country lags other developed nations in important health measures, such as life expectancy and infant mortality.
Many lawmakers agree on the need for Medicare payment reforms to encourage better care at lower costs. More controversial proposals involving the government’s role in covering the uninsured and how to pay for it are to be discussed by the committee over the next few weeks.
(Editing by Vicki Allen)