New Democrat Coalition Sets 2012 Healthcare Priorities

The New Democrat Coalition, which promotes itself as a group of centrist House Democrats, released a white paper Friday that describes its healthcare policy priorities for 2012.

Cue the soaring music as the New Dems go way out on a political limb (not) and declare their support for a new Medicare payment system that rewards quality, new delivery models that increase efficiency, an FDA approval process that moves more quickly, and widespread adoption of health IT systems.

The list may sound familiar because it encompasses many of the tenets of the 2010 Patient Protection and Affordable Care Act. So what's the point? A Congressional insider, who asked not to be identified, calls the 900+-page PPACA a "work in progress," with the Department of Health and Human Services and the Centers for Medicare & Medicaid charged with connecting the dots to develop a coordinated care system that emphasizes quality and efficiency. "The coalition will continue to put out proposals and weigh in at the regulatory level," my source says.

So think of this white paper, New Democrat Coalition Principles for Supporting Innovation in our Nation's Health Care System, as a political line in the sand. It puts Republicans and other Democrats, as well as HHS and CMS, on notice that the 42-member coalition is united in its focus on this shortlist of priorities to advance the continued implementation and refinement of PPACA. With the exception of the FDA proposals, the coalition won't be fighting for new legislation. Mostly it will hold committee hearings and schedule dialogue with regulatory agencies.

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.

2.Facilitate cooperation between the public and private sectors to promote successful implementation of healthcare delivery models that increase efficiency and improve patient care.

• Facilitate participation in new Medicare delivery models by allowing successful multi-payer demonstrations to expand to traditional Medicare fee-for-service beneficiaries.
• Enable private payers to invest in infrastructure development for smaller practices that want to develop or participate in innovative care delivery models.
• Improve consistency in data collection and analysis across Medicare shared savings programs.
• Consolidate elements of various shared savings programs such as quality reporting systems and technical assistance to conserve resources.
• While protecting patient privacy, increase de-identified data sharing across the Medicare program to allow for more accurate comparisons of spending and outcomes.
• Invest in enhanced research, better care coordination, and disease management through continued support for providers and third-party payers to reduce the burden of ICD-10 conversion.

3.Modernize the FDA approval process to foster innovation, growth through competition, and timely patient access to new treatments and technologies.

• Ensure that the FDA has the funding and Congressional support to carry out its mission.
• Ensure that the FDA uses its funding more efficiently to meet its performance targets and keeps a concentrated, top-to-bottom focus on innovation.
• Engage industry stakeholders to better assess the cost of moving products through the FDA approval process.
• Build on the successful practices demonstrated through FDA's 510(k) approval process that allow safe and effective technology and innovations to get to market in the most efficient way possible.
• Address uncertainties in the FDA approval process by setting explicit and transparent guidelines for drug and device manufacturers.
• Foster an open dialogue between regulators and the private sector to reduce administrative burdens on both sides.

4.Promote widespread adoption of interoperable health information technology (HIT) systems across healthcare settings to reduce costs and provide savings for patients and businesses.

• Foster an HIT marketplace where small providers and hospitals, as well as providers in disadvantaged communities, can reduce financial risks associated with HIT investments and become meaningful users of comprehensive, affordable HIT systems.
• Make sure meaningful use standards are focused on outcomes as well as inputs.

What will happen to this list of priorities is anyone's guess. Efforts to garner a comment on the white paper from Rep. Joe Pitts (R-PA) were unsuccessful. Pitts chairs the House Energy and Commerce Committee's Subcommittee on Health, which regularly holds hearings on many of the topics on the agenda of the New Democrats. There is general agreement across the political aisle that quality and efficiency are important to the success of our healthcare system—but how to pay for everything is always a stumbling block.