Sunday, September 14, 2008

Hearing Addresses Quality

Chairman of the Senate Finance Committee, Senator Max Baucus (D-MT), reported that the Committee has been holding a series of hearings on health reform. Previous hearings and a roundtable have explored ways to control healthcare costs and ways to expand access to care. The most recent Committee hearing on healthcare issues was held on September 9th, to discuss healthcare quality issues.

Peter V. Lee Executive Director of National Health Policy Pacific Business Group on Health presented ideas on achieving quality and value in health reform. First of all, Lee emphasized that we must understand what works since all too often, we don’t know which drugs, devices, or treatments are the right ones to use. Drugs, devices, and procedures need to be measured to be able to compare their effectiveness.

Lee suggested that comparative performance information be made available to all providers with information on treatments, payments, and incentives. Performance reports need to include patient outcomes, how the patient views the care, and as to whether the right care is being delivered by doctors, medical groups, hospitals, nursing homes, and other providers. The resulting information needs to be considered by public and private plans in benefit design, coverage, payment decisions, and in providing patient decision support.

As many have pointed out, healthcare needs to be reengineered and outdated methods currently used to deliver care need to be eliminated. For example, Lee pointed out recent legislation is now enables Medicare to provide incentives for e-prescribing, Medicare should also reimburse providers for electronic consultations with patients, and allow for physician assistants, nurses, pharmacists, nutritionist, and dietitians to provide more care if they are appropriately trained.

Lee wants to see Medicare develop payment reforms that will support care coordination so that providers will have incentives to redesign care settings to encourage medical providers to work in teams. Changes in payments also need to be made to compensate medical professionals for the time that is spent with patients to help them learn to manage their own health and care.