Health executives debate legislation

• By TED GRIGGS
• Advocate business writer
• Published: Oct 30, 2009 - Page: 6B

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A public insurance option and paying for health-care changes have drawn the most controversy in Congress, but proposed bills contain many measures that could actually lower costs and improve care, a national business group’s head said Thursday.

“Hidden in those 800 pages of legislation are some provisions where there’s very little attention, but I do think (they) speak to the real issues of reform,” said Andrew Webber, president and chief executive officer of the National Business Coalition on Health.

Among other things, the proposed legislation contains requirements to change reimbursements; provide more in-depth quality measurements through the National Quality Forum; support research in comparing the value and benefit of different health-care services and how that can be a factor in benefit coverage decisions; and investments in health information technology that will enable the creation of more coordinated care, as well as allow the measurement of outcomes and performance over time.

There are also provisions to create innovation centers and expand pilot and demonstration projects to broad application, Webber said.

“In these bills, there are some very good provisions on these sorts of issues that aren’t being talked about,” Webber said.

Webber was the guest speaker at the Louisiana Health Care Alliance and Louisiana Business Group on Health’s annual meeting. The first group consists of health-care providers, insurers and employers whose goal is to improve the quality and value of health care. The second group represents mainly employers and lobbies on their behalf.

Bill Borne, the Amedisys Inc. chief executive and outgoing chairman of the groups, said employers, providers and insurers need to pay attention to the difference between pilots and demonstrations.

“Demonstration is one in a lifetime. If it’s OK, you take it, maybe go back and legislate it,” Borne said. “If it’s a pilot, then it’s something that if it proves to be successful then it can be replicated, disseminated and distributed.”

Borne said another thing that’s being lost in the debate is that health care works OK for the majority of people.

The focus is on the 50 million or so Americans who don’t have health insurance, Borne said. The problem is that none of the proposed bills take care of that entire population.

Borne said he expects to see some changes covering payment sources, but there won’t be big changes in the way providers deliver health care.

Early next year, Borne said groups of hospitals, doctors and post-acute providers, such as home health companies, will be organized into “accountable care organizations.”

These groups will provide bundled services for care, Borne said. Borne said his firm, one of the country’s largest home health companies, has already been asked to join one such group.