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C-suite group offers payment reform idea

Medicare & Reimbursement Advisor Weekly, June 17, 2009

A group of healthcare CEOs, including a representative from Merck, urged Congress June 12 to move ahead with reform plans to improve patient access to care, reduce cost growth, and enhance quality.

Among the proposals the group made were:

• Switch Medicare fee-for-service payments with outcome-driven bundled payments
• Hold higher-cost providers accountable to the cost, quality, and utilization standards reached by more efficient peers
• Give providers a bundled payment, based on comprehensive services and shared risk
• Regionalize high-cost, resource-intensive services under Medicare
• Continue investments in quality infrastructure, including health information technology, decision-support tools, and comparative effectiveness research

The group, called Health CEOs for Health Reform, issued a white paper that focused on creating a new payment system that they said would reward high-quality care while discouraging fragmented low-value care.

Overall, “we do know how to deliver care differently,” said Nicholas Wolter, MD, of the Billings (MT) Clinic. With more physician-hospital organizations and other integrated approaches emerging, changes can occur, but it has to happen “fairly quickly because we do not have longer than five to 10 years to deal with what is truly becoming not just a healthcare burden, but a burden on our entire society.”

Other members of the CEO team are Bruce Bodaken, president, chair and CEO, Blue Shield of California; Lloyd Dean; president and CEO, Catholic Healthcare West; Kenneth C. Frazier, president, Global Human Health, Merck & Co. Inc.; Patricia A. Gabow, MD, CEO and medical director, Denver Health; Gary Kaplan, MD, chair and CEO, Virginia Mason Medical Center; Donna Katen Bahensky, president and CEO, University of Wisconsin Hospital and Clinics; and Anthony R. Tersigni, EdD, FACHE, president and CEO, Ascension Health.

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