Originally published in the Philadelphia Inquirer, June 22, 2015
Efforts to improve quality while reducing cost in health care are changing the way we pay doctors and provide care for our seniors.
After decades of “fee-for-service” payments – meaning payments for individual visits and tests – there is now a determined effort to reward “value-based care.” The idea is that we should be rewarding quality care that improves health – not just episodes of service.
After years of debate, Congress and the Obama administration have taken important action to drive this positive change for seniors and for all Americans. And Medicare, the nation’s largest health-care program, is at the center of this transformation.
During my decade of service in Congress, I worked on many issues, but nothing was more important to me then ensuring quality, affordable, accessible health care for all Americans, particularly our seniors.
I worked to ensure that we could meet our nation’s promise to seniors today and into the future by improving Medicare. This meant promoting innovations like electronic medical records so health practitioners in different settings would have critical information at their fingertips to save lives – and dollars. And it meant advocating expanded access to primary care and reimbursement for patient-centered, coordinated care, particularly for those with serious chronic conditions.
I am proud to see many of these innovations in place today.
Working with members on both sides of the aisle, I pushed to modernize Medicare payments and reward doctors for quality and accountability. I promoted payment and delivery reforms that would bring better-quality care that is more accessible and effective for seniors. The fact that these reforms are now advancing throughout all of Medicare is a great step forward.
The next step is to be sure that they are available to seniors across the country.
The good news is that this is happening today under Medicare Advantage plans. Value-based care is available and proving effective under Medicare Advantage plans across America.
Medicare Advantage plans are successfully providing more than 17 million seniors with high-quality, coordinated care – nearly one-third of all beneficiaries. In Pennsylvania, nearly 40 percent of Medicare beneficiaries are enrolled in Medicare Advantage plans. The program’s affordability and simplicity, as well as its preventive services and chronic-disease management, are also appealing to large numbers of seniors nationwide.
Medicare Advantage plans are leading the way in bringing financing in line with the kind of care that can make a difference for millions of seniors and their families. And when these plans lower spending and achieve savings, these savings are used to enhance benefits. As a result, most plans that already include a drug benefit and supplemental benefits can add coverage for dental, hearing, vision, transportation, or fitness benefits at no extra cost to beneficiaries.
Seniors value the enhanced benefits, the affordability, and the simplicity.
Practitioners appreciate the opportunity to work together as a team to provide the right care to their patients and to offer options for follow-up and home care not otherwise available.
Strong quality measures foster accountability and encourage patient engagement and better communication among physicians. As a result, patients experience greater continuity of care and smoother transitions from one medical setting to the next, whether at home, in the hospital, or at other points of care.
Medicare Advantage is clearly leading the way in offering coverage for value-based care. And members of Congress of both parties have recognized this value. Just this year, a majority of representatives and senators called for stability of Medicare Advantage as an option for America’s seniors. I commend Congress for supporting and protecting this critical option under Medicare.
Medicare Advantage is the future of health care for America’s seniors. With its focus on primary care, greater care coordination, high patient satisfaction, and strict accountability for quality and cost, it points the way toward the future for seniors – and maybe for all of us.
It is an exciting and important time in health care. And I am proud to be able to do what I have always done – to advocate for health policy that works for patients and providers, ensures our promise of Medicare for all seniors, and sets a positive example for the entire health-care system. Medicare Advantage works. And there is no better time to spread the word.