In 11th hour negotiations last weekend with representatives from the White House and several House members who belong to the Quality Care Coalition, Health and Human Services Secretary Kathleen Sebelius presented a letter indicating that Medicare may be soon moving away from a fee-for-service system to a more quality- and value-based system.
In the letter, Sebelius promised steps to improve Medicare reimbursement rates for physicians and hospitals in regions of the country—particularly the Midwest and Pacific Northwest, where providers say they have been paid less for the delivery of care that may be more efficient—but smaller in volume.
In the letter, she called for:
The 30-member Quality Care Coalition includes representatives primarily from Midwestern, Pacific Northwest, and rural states, who have complained that they have been strapped with low reimbursement fees over the years while often providing more efficient care.
As part of the reconciliation process, the House Rules Committee included on March 20 a new section, "Payment for Qualifying Hospitals," that would provide additional funding from the Medicare Hospital Insurance Fund for hospitals located on counties within the lowest quartiles of payment.