Health reform tops Obama's legislative agenda
Posted By: Steven Lipstein 
Date Posted: July 4th, 2009 Category: Health Care
The plight of almost 50 million uninsured fellow citizens in our country, the continually rising costs of health care and the combined impact of both on working families and businesses alike, have landed at the top of President Obama’s legislative agenda. The focus is welcome and overdue, but health care reform is a monumental undertaking that will take years of hard and serious work. As a provider of health care services and the area’s leading employer of health care professionals, we have a vested interest in what changes will occur and how they will be implemented.
Earlier this month, the U.S. Senate Committee on Finance released a lengthy and complicated collection of policy options that most analysts believe will begin to gain some traction this year, with full implementation being phased in over the next decade. These are proposals that will no doubt have a profound impact on what we do and how we do it. To help us get ready, we created a new leadership position to create a BJC-wide approach to understanding the policy implications of health care reform, how each policy will be implemented and over what timeframe, an assessment of how well BJC is positioned to adapt, and what actions we will need to take. As I said at the outset, there is much work to do. Some areas that are targeted for reform include:
- Payment – Several proposals look at how health care organizations should be paid in the future. They include value-based purchasing programs for hospitals, home care agencies and skilled nursing facilities; physician quality reporting programs; transparency and evidence-based decision making for imaging services; quality reporting for inpatient rehabilitation and long-term acute care facilities; and rate adjustments for primary care, general surgery and transitional care.
- Coordination – A number of proposals are designed to increase collaboration among providers including innovation in chronic care management; bundling payments for hospital readmissions; and moving away from fee-for-service reimbursements to payments that hold providers financially accountable for outcomes.
- The balance of the reform agenda includes workforce proposals affecting graduate medical education (GME) reimbursement; changes to Medicare Advantage plans; options to combat fraud, waste and abuse; cost and quality transparency; and efforts to encourage that treatment is based on sound evidence and proven effectiveness, also called comparative effectiveness research.
The policy proposals are sweeping and ambitious and are sure to stimulate much discussion and debate. But, we will be prepared to understand and respond to the changes that are on the horizon. Transformation of our health care system is a good thing. We have been preparing for these changes for some time now. Learning and innovation, better health and better health care are the goals of health care reform – sound familiar?