Sup­port­ing play­ers

Provider groups back re­form bill—with caveats

Modern Healthcare - - The Week In Healthcare - Matthew DoBias and Jen­nifer Lubell

As the fi­nal pieces fell into place last week on a $940 bil­lion leg­isla­tive pack­age that could re­shape the na­tion’s health­care sys­tem, in­ter­est groups made their fi­nal push for or against the House bill.

Providers largely came out in sup­port of the leg­is­la­tion. Most had pre­vi­ously cham­pi­oned some type of re­form, al­though some dif­fered on how to achieve it.

“No leg­is­la­tion is per­fect,” said Chip Kahn, pres­i­dent and CEO of the Fed­er­a­tion of Amer­i­can Hos­pi­tals, which en­dorsed the re­form mea­sures on March 18. “Congress will re­visit this leg­is­la­tion as it has most re­form (bills) again and again.”

While the fed­er­a­tion, which rep­re­sents in­vestor-owned hos­pi­tals, and oth­ers have fo­cused sharply on get­ting leg­is­la­tion signed by Pres­i­dent Barack Obama, they have also pledged to their mem­ber or­ga­ni­za­tions that they would con­tinue to tweak pro­vi­sions ei­ther on Capi­tol Hill or at the agency level. “We’ll look at its ef­fects,” Kahn said. “We’ll have views and prob­a­bly want some­thing to evolve.”

Physi­cian groups sounded a sim­i­lar mantra. While not nec­es­sar­ily pleased with all of the bill’s pro­vi­sions, for the most part they agreed that the greater ef­fort to get more Amer­i­cans in­sured and con­trol costs over­rode the bill’s im­per­fec­tions. The sched­ule at dead­line called for the House to vote on the leg­is­la­tion on March 21 and for the Se­nate vote to take place af­ter that, pos­si­bly late this week.

On March 19, the Amer­i­can Med­i­cal As­so­ci­a­tion, which op­posed re­form ef­forts in the past cen­tury, an­nounced “qual­i­fied sup­port” for the lat­est pro­posal.

“The pend­ing bill is im­per­fect, but we can­not let the per­fect be the en­emy of the good when it comes to some­thing as im­por­tant as the health of Amer­i­cans,” AMA Pres­i­dent J. James Ro­hack said in a writ­ten state­ment. “By ex­tend­ing health cov­er­age to the vast ma­jor­ity of the unin­sured, im­prov­ing com­pe­ti­tion and choice in the in­sur­ance mar­ket­place, pro­mot­ing preven­tion and well­ness, re­duc­ing ad­min­is­tra­tive bur­dens, and pro­mot­ing clin­i­cal com­par­a­tive ef­fec­tive­ness re­search, this bill will help pa­tients and their physi­cians.”

His qual­i­fied en­dorse­ment was echoed by Jack Lewin, CEO of the Amer­i­can Col­lege of Car­di­ol­ogy.

“We have been urg­ing Congress to fix the ac­cess-to-care prob­lem, to come up with leg­is­la­tion to pro­mote qual­ity of care and pay­ment re­forms, to make cov­er­age af­ford­able to those who can’t af­ford it, to ad­dress chronic dis­ease man­age­ment, preven­tion and well­ness,” Lewin said. He noted that to that end, the leg­isla­tive pack­age con­tains ad­di­tional fund­ing for chil­dren and adults with con­gen­i­tal heart dis­ease.

What physi­cians are likely to op­pose is the in­clu­sion of an “oner­ous” in­de­pen­dent pay­ment ad­vi­sory board that ex­cludes all other health­care sec­tors ex­cept for doc­tors, he said. “I don’t think it’s a very good mech­a­nism” for de­ter­min­ing re­im­burse­ment, he said.

Ro­hack: “We can­not let the per­fect be the en­emy of the good.”

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