Saving money and improving health care quality

As a representative of a consumer health organization, whose mission and purpose is to advocate for quality, affordable, patient-centered medical care, I want to applaud the Senate for creating proposals that will expand access to insurance and ensure quality care and value for our dollar.  First and foremost, the legislation addresses the urgent need to provide coverage for those currently without health insurance, and secondly, the bill is fiscally responsible. 

 The Senate bill takes us a long way toward achieving coverage expansion and cost-growth containment.  We know that these two items must be done at the same time for failure to do so would create intolerable burdens.  For example, if we control costs without expanding coverage the burden would fall on our hospitals and safety net providers.  We would essentially be asking providers to continue to see millions of uninsured people while lowering their costs overall. On the flipside, if we expand coverage without cost-growth containment it would be fiscally irresponsible and unsustainable. 

 The expansion and cost-control measures found in the Senate bill seek to improve the quality of care individuals receive.  For instance, the bill looks at ways to preserve programs like Medicare while containing costs and improving efficiencies. It links payment to productivity and builds value-based payment models.  It essentially, changes the current system of pay-for-reporting to one of pay-for-quality.  This means that payments would be made based on the quality of services and better health outcomes rather than the number of services or tests performed.

 As we expand coverage, the Senate bill also addresses the need for new models of delivering health care.  Many of these new programs are designed to improve care coordination and prevent unnecessary hospital readmissions.  The significant savings obtained by better quality measures offers providers the opportunity to share any savings obtained by coordinating their patient’s care.  This model of an accountable care organization would produce better quality for consumers at lower costs by offering providers incentives. 

Along the lines of new models for delivering care, the Senate bill implements key measures to prevent costly hospital readmissions.  This initiative would hold hospitals accountable by reducing payments to institutions who fail to lower unnecessary and avoidable readmissions. 

Finally, the Senate’s health reform bill creates mechanisms for ongoing innovations.  It would expand the collection and dissemination of unbiased data to both patients and providers to help them make better and more educated treatment decisions.

While there are no easy answers when it comes to health care reform, the Senate’s bill lays the groundwork for holding the health care system, both public and private, accountable for cost-growth and quality.  Certainly, expanding coverage will increase costs in the short-term, but the health care delivery, quality, and payment reforms contained in this bill will offer a framework for lowering health care costs in the long-term.  Ultimately, how these policies are implemented will determine their success.  The key to sustainable reform is to balance the need for change and make sure change is done correctly.

 My organization looks forward to ongoing advocacy and action in this exciting period and shared journey of national health care reform.

©2016 Consumer Health Coalition.
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