Here are some highlights.
Medicare payments
* Allows a 0.5 percent increase in physician payments for 2010, rather than the scheduled 21 percent reduction, but does not fix the sustainable growth rate formula that caused the increase.
* Reduces payments for disproportionate share hospitals, advanced imaging services, home health and Medicare Advantage plans.
* Creates productivity adjustments and additional reductions in market basket updates for hospitals.
Pay-for-performance and quality initiatives
* Creates value-based purchasing programs for hospitals and physicians.
* Sets up payment penalties for hospital-acquired conditions.
* Requires HHS to maintain a national strategy for health care quality measurement and improvement.
* Establishes accountable care organization and hospital readmission reduction programs.
* Creates a national pilot program for payment bundling.
* Launches a demonstration program for chronically-ill beneficiaries to receive home-based primary care.
Medicare Advisory Board
* Establishes a 15-member independent Medicare Advisory Board that would present Congress with proposals for reducing excess Medicare cost growth.
* Requires the board to propose cost constraints when Medicare costs are projected to exceed a target rate, and the board’s plan would go into effect unless Congress developed an alternative proposal.
* Bars the board from reducing payments for providers if their payments were already reduced by market-basket adjustments.
Transparency and program integrity
* Prohibits new physician-owned hospitals from participating in Medicare after Feb. 1, 2010.
* Device-makers, drug-makers and other healthcare industries would be required to report most transfers of value to physicians or interests involving physicians, and most of the information would be put on a searchable public database.
* Requires physicians who refer patients for ancillary services within their group practices to inform patients that they can also receive the services from other physicians.
Requires charitable hospitals to make periodic community needs assessments.
Read Health Affairs‘ report on the Senate health reform bill.
