New Democrat Coalition Sets 2012 Healthcare Priorities

Margaret Dick Tocknell, for HealthLeaders Media , December 14, 2011

In general, the proposals call for closer cooperation between the public and private sectors to achieve innovative healthcare solutions. There is also an emphasis on not reinventing the wheel by getting the public sector to quickly incorporate best practices that have already been tested in the private sector. The Blue Cross and Blue Shield Association, for example, has touted a series of steps its health plans have taken that could result in $319 billion in savings for the Medicare and Medicaid programs.

And although it isn't clearly stated in the white paper, the innovation emphasis is apparently a warning to Republicans that the group supports the work of the CMS Center for Medicare and Medicaid Innovation. The GOP has made noise about cutting the center's funding.

Here's a look at some of the New Democrats' healthcare priorities:

1.Structure the Medicare payment system to reward quality and value while reducing costs for patients and providers.

  • Phase out the sustainable growth rate and replace it with a value-driven system that emphasizes quality of care over volume.
  • Transition from the fee-for-service reimbursement model to create a variety of physician payment models, including bundled payments, risk-adjusted capitation, and global payments.
  • Consider the impact of Medicare, Medicaid, and private insurance reimbursement policies on current and projected workforce shortages in the health professions.
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