The Health Reform Dialogue (HRD) a prominent group of organizations on Friday released a laundry list of recommendations for health care reform.
The HRD is hopeful to enact meaningful health care reform, and includes a diverse group of members from Families USA, and Blue Cross – Blue Shield Association to the National Federation of Independent Business (NFIB), American Medical Association (AMA) and Pharmaceutical Research and Manufactures Association (PhRMA).
They are proposing reforms in the broadest sense and have left the subject of universal coverage alone for the time being.
Some of their recommendations include:
· Improve Medicaid and Children’s Health Insurance Program (CHIP) outreach and enrollment.
· Establish a nationwide floor for Medicaid eligibility for all adults no lower than 100 percent of the federal poverty level.
· Provide federal funding to the states for expanding Medicaid.
· Set standards for additional federal Medicaid funding during economic downturns.
· Restore legal immigrants’ eligibility for Medicaid coverage to mirror CHIP.
· Give individuals eligible for Medicaid and CHIP the option to utilize those dollars to purchase employer-sponsored insurance, so long as full Medicaid or CHIP wrap-around coverage is available.
· Provide advanceable, refundable tax credits or other subsidies on a sliding scale for individuals and families to purchase adequate and affordable coverage, which includes effective preventive services.
· Provide additional assistance for out-of-pocket costs for low-income people and families.
· Provide subsidies for small businesses to provide health insurance for their employees.
· Provide a fair and transparent marketplace for purchasing insurance regardless of health status, age, or other factors.
· Enact reforms necessary so that all individuals will purchase or obtain quality, affordable health insurance.
· Ensure adequate payment to clinicians and providers by public programs to assure access to care.
Broad recommendations around prevention are those that no one would disagree with and include:
· Identify effective clinical preventive services.
· Facilitate patient utilization of effective clinical preventive services.
· Promote coverage of effective clinical preventive services.
· Encourage clinicians and providers to deliver effective clinical preventive services and follow-up treatment, as indicated.
· Ensure a sufficient primary care workforce through an ongoing, dynamic, national planning and development process.
· Continue to invest in health information technology (HIT) that supports wellness and prevention, both on the individual and community levels.
· Identify existing health promotion “promising practices” and barriers to implementation.
· Identify where there are gaps in knowledge about the most effective health promotion practices, and invest in research to fill those gaps.
· Collect and disseminate information on wellness and health promotion.
· Further encourage businesses to support healthy behaviors.
· Encourage communities to be healthy.
· Eliminate disparities in health.
· Help individuals improve their health.
To improve quality in heath care they looked at a broad range of issues including government funds for health care IT.
· Develop infrastructure to close gaps in quality and outcomes.
· Conduct comparative clinical effectiveness research (CER) studies via a public-private partnership to provide additional information that can help improve care decisions.
· Expand and accelerate the development of meaningful quality measures.
· Expand reliable data sources to build an evidence base for quality care.
· Fund state demonstrations of alternative medical liability reform models.
· Develop standards to guide clinician and provider performance reports to ensure the accuracy, reliability, and utility of such reports and the measures used to develop them.
· Build on current efforts to provide federal support, including clinician and provider incentives, for implementation of a strong HIT infrastructure that has the capabilities needed to improve patient care.
· Consider the potential effect of new payment methodologies on medical innovation.
· Develop clinician and provider incentives, aligned to evidence-based practices, based on measures and standards created and endorsed by professional membership societies and other bodies and through a multi-stakeholder process.
· Research, develop, and implement Medicare payment reforms to improve prevention and facilitate coordination of care.
· Improve billing efficiencies to reduce confusion and duplication for patients, clinicians, and providers.
· Reduce administrative costs.
· Align incentives to promote patient-centered care including innovative delivery models, including but not limited to, the patient-centered medical home model.
· Address barriers to investing in quality improvement.
· Work to reduce geographic, racial, ethnic, and gender disparities in health care delivery.
· Ensure an adequate health care delivery workforce, including funding for training and loan forgiveness programs and payment reforms directed at primary care, public health and nursing, and other high-priority areas facing imminent shortages.
These are serious recommendations and though many like are being adapted without government intervention.
One large barrier to healthcare for small employers like our company is the cost of the insurance, though we have offered health insurance to our employees since our inception, the costs are astronomical.
So proposals that provide subsidies for small businesses to provide health insurance for their employees even if it was in the form of tax breaks would be very helpful and help finance additional jobs in our economy.
This is a really big deal that these groups representing employers, providers, payers, and manufactures who have been opposed to each other on so many issues can agree on such a long list.
The inclusion of NFIB, America’s Health Plans, PhRMA and AMA which were four of the largest contributors to stopping the Clinton era health care reform effort, signals that there significant progress in both the thinking of these organizations and the policy makers.
There has to be some measure of sanity if we are going to reform the health care system. These proposed reforms go a long way to getting us there