National Partnership for Women & Families

Leading Consumer Expert Urges Bold Improvements on Physician Payment Policy

Statement of Debra L. Ness, President National Partnership for Women & Families
Washington, D.C. — August 31, 2009 —
“Even as legislators on Capitol Hill work towards meaningful health insurance reform for our future, we have an immediate opportunity to make bold and badly needed changes in how we pay for health care. As the Centers for Medicare & Medicaid Services (CMS) revises the 2010 Physician Fee Schedule, we applaud CMS for taking steps to move the health care system closer to a pay-for-value rather than a pay-for-volume system a move that’s critical to ensuring high quality care and getting better value for our health care dollar.

Today, our health care system only delivers the right care, at the right time, for the right reason, about 50 percent of the time. We can do better. The National Partnership is urging CMS to take additional steps to reward high quality care and create incentives for coordinating care among providers by tying an increasing proportion of payments to improved performance levels. We also support closing the pay gap between primary care physicians and specialists, so that primary care physicians can increasingly focus on delivering the management and care coordination services that patients and their families need.

We also urge CMS to set higher standards for using information technology like e-prescribing, and ensure synergy between the incentives outlined in the proposed rule and those in the definition of “meaningful use” recommended by the HIT Policy Committee. Provider payment must be aligned in these areas if we are to get the most value for our dollars.

As consumers are expected to take an increasingly active role in their health care, CMS should do even more to help ensure they have access to good information about hospitals, doctors and treatments as they make medical decisions. That’s why all measures in the Physician Quality Reporting Initiative (PQRI) should be publicly reported, and CMS must begin to shift this program toward one that pays for performance on those measures.

Finally, if we are serious about changing payment policy to advance proposals we know will save money and make health care better, the process for deciding payment policy at CMS must include the voices of health care purchasers and consumers. It is critical that CMS establish a panel of consumers, employers, and independent unbiased experts to guide future decisions on payment values for physician services.

While the current health insurance reform debate unfolds, consumers and patients are counting on their leaders to take every opportunity to make improvements to our broken health care system. CMS has an opportunity to get it right, right now, and build a system that brings us closer to high quality, affordable care for everyone.”

Contact

Cindy Romero (202) 986-2600 cromero@nationalpartnership.org

The National Partnership for Women & Families is a nonprofit, nonpartisan advocacy group dedicated to promoting fairness in the workplace, access to quality health care and policies that help women and men meet the dual demands of work and family. More information is available at www.NationalPartnership.org.

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