Members Discuss Opportunities and Proposals to Modernize Medicare Payment Structures
WASHINGTON, DC – Continuing its efforts to keep the promise of Medicare for the nation’s seniors, the House Energy and Commerce Subcommittee on Health today discussed ways to modernize and reform Medicare payment structures to help strengthen the program. Subcommittee members also discussed legislation designed to make the Medicare payment process more efficient: H.R. 2869, the Medicare Patient Access to Cancer Treatment Act, introduced by committee member Rep. Mike Rogers (R-MI) and H.R. 4673, to amend title XVIII of the Social Security Act to provide bundled payments for post-acute care services under parts A and B of Medicare, introduced by committee member Rep. David McKinley (R-WV).
Full committee Chairman Fred Upton (R-MI) commented, “The Medicare program is an important lifeline for millions of seniors and disabled Americans, but its deteriorating fiscal state is putting that lifeline at risk. Our committee remains focused on steps Congress can take to preserve the promise of Medicare for those who rely on the program, both today and for generations to come. The Medicare Payment Advisory Commission, or MedPAC, has put forward a number of proposals that it believes would improve the effectiveness of Medicare by equalizing payments for the same service regardless of where it is delivered. These could potentially reduce out-of-pocket costs for seniors, while saving billions for taxpayers, by making sure care is delivered by the institutions that do so best.”
Health Subcommittee Chairman Joseph R. Pitts (R-PA) added, “As the subcommittee with the largest health jurisdiction of any committee in the House, we are charged with safeguarding the Medicare program and preserving it for future generations. As such, I and Ranking Member Pallone felt it important for the members of this subcommittee to hear the pros and cons of potential policies in this space.”
During the hearing, Mark E. Miller, Executive Director from the Medicare Payment Advisory Commission (MedPAC) testified, “The Commission’s goal is to achieve a Medicare program that ensures beneficiary access to high-quality care, pays health care providers fairly, rewards efficiency and quality, and spends tax dollars responsibly. When we examine Medicare’s payment policies across different sites of care, we observe several opportunities for policy development. … Several of these policies could be implemented in the near-term and would serve as building blocks for broader payment reforms. In the future, the Commission envisions Medicare moving toward payment systems that are based solely on the needs of the patient, irrespective of the site of care, and that give providers greater accountability over the quality and cost of the care provided to Medicare beneficiaries.”
H.R. 2869 would reimburse cancer care services equally regardless of the location in which they were provided. Rogers explained the need for the change: “The United States is home to the most effective and successful cancer care in the world, creating an environment that has resulted in the best cancer survival rates across the globe. However, in the last five years, a troubling change in the delivery of cancer care has begun to emerge. Since 2008, community oncology clinics have seen the shift from physician office setting to the hospital outpatient department as a result of the flawed Medicare payment policies that reimburse hospitals at higher rates than oncology clinics for the exact same service. These changes have serious implications on patient access, especially in rural areas where radiation therapy is not always available through local hospitals.”
The other bill highlighted today, H.R. 4673, would combine the various payments for post-acute care services into one reimbursement bundle. McKinley said, “For the past two years our staff has been working with various stakeholders to create a program that would make Medicare more efficient and improve healthcare for seniors without making cuts to provider payments. … This bill develops a model for post acute care services which will increase efficiency, encourage more choice, personalize care for patients, and offer significant savings to the program in the process.”