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How Do Five Quality and Value Issues Fare Under the Senate Reform Bill?

Janice Simmons, for HealthLeaders Media, November 24, 2009

While approaches to public insurance options and health exchanges have dominated the discussions of the House and Senate healthcare reform bills, issues addressing quality and value have been threaded through the bills, sometimes matching each other, sometimes showing some differences in the individual bills.

Here are some examples:

Medicare and Medicaid Payment Innovation Center. Both the House and Senate bills would require the Centers for Medicare and Medicaid Services (CMS) to develop and test innovative payment and care delivery models that emphasize coordination of care, quality improvement, and efficiency. These would include patient-centered medical homes, accountable care organizations, and bundled payments for hospital acute and post-acute care. The Senate bill also would implement a national, voluntary shared savings program for accountable care organizations.

Healthcare associated infections. Under the Senate proposal, hospitals with high rates of hospital acquired infections would have their Medicare reimbursement rates cut by 1%. In the House bill, hospitals and ambulatory surgical centers would be required to report public health information on healthcare associated infections to the Centers for Disease Control and Prevention.

Patient Centered Outcomes Research Institute. The Senate bill calls for creation of an independent, nonprofit institute governed by public and private sector representatives to provide for research designed to "inform the decisions of patients and providers" regarding the clinical effectiveness of different medical treatments and services available for the same condition.

The Agency for Healthcare Research and Quality would disseminate research findings from the Institute and other government funded sources.

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