Five Healthcare Stakeholders Voice Support, Concern for Senate Bill

Janice Simmons, for HealthLeaders Media , December 21, 2009

As the Senate heads for a potentially eventful week of debate and votes on health reform, a number of healthcare organizations are stepping forward with their support and opposition to the plan.

In a letter to Sen. Harry Reid, Rich Umbdenstock, president and CEO of the American Hospital Association, said it strongly supports the bill's "approach to increasing competition in the insurance market and providing more choices to patients, utilizing non-governmental, nonprofit entities to provide coverage, and rejecting a further expansion of public programs that do not compensate adequately for the cost of care."

The AHA also supports "meaningful delivery system reforms" such as bundling of physician, hospital, and post acute services, and allowing hospitals to take a leadership role in accountable care organizations, said Umbdenstock.

However, Umbdenstock added AHA has concerns about cutting payments to Medicare and Medicaid disproportionate share hospital programs and the Medicare hospital update. In addition, "policy and reductions related to hospital readmissions are problematic, and may penalize hospitals for readmissions that are unavoidable."

Chip Kahn, president of the Federation of American Hospitals (FAH), said that FAH was "particularly pleased" that the bill "as amended, would increase access to affordable, quality coverage; create market based exchanges with private coverage and subsidies for lower income Americans; and implement important delivery reforms such as value based purchasing, a prospective ban on self referral to physician owned hospitals, and voluntary pilots to test bundled payments across an episode of care."

However, he noted, the bill as amended would "benefit from further improvements in several important areas", including covering more uninsured Americans [the current predicted rate is 94%]. Also, the hospital readmissions policy "falls short by not sufficiently focusing on those readmissions that are preventable and avoidable," he said.

The American Medical Association (AMA) also announced its support for passage of the amended Senate health system reform bill, which it said would "bring our nation close to the finish line on health system reform."

The AMA said the bill would improve choice and access to affordable health insurance coverage and eliminate denials based on pre-existing conditions as well as increase coverage for preventive and wellness care.

"All Americans deserve affordable, high-quality health coverage so they can get the medical care they need—and this bill advances many of our priority issues for achieving the vision of a health system that works for patients and physicians," said AMA President-elect Cecil B. Wilson, M.D.

Though the AMA spoke positively of the bill increasing payments to primary care physicians and general surgeons in underserved areas, the organization said there is still work needed in the areas of creating a Medicare payment board, quality improvement, and Medicare data release initiatives. Congress should also permanently repeal the current Medicare physician formula.

"The AMA will stay engaged in the process to ensure that the final bill that goes to President Obama for his signature will improve the healthcare system for patients and physicians," said Wilson.

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