Medicare value index survives Senate debate

MINNEAPOLIS, December 21, 2009 - Senate Democrats won a milestone victory early Monday in the health-care debate, approving a procedural motion to move the reform legislation to final passage later this week.

The 60-40 tally, taken shortly after 1 a.m. was the first of three procedural hurdles that Democrats must cross before a final vote on passage of the measure, now scheduled for Christmas Eve.

Included in the measure was a Medicare value index for paying physicians, which was authored by Sen. Amy Klobuchar.
Sen. Amy Klobuchar released a statement, according to Minnesota Public Radio, saying that the final package includes provisions that she has been advocating for inclusion in the bill.

"The EARLY Act helps young women battling breast cancer, the Medicare fraud amendments will save billions of dollars for our taxpayers, the one-year delay in implementation of the medical device tax was important to our job-creating medical device industry, and, most importantly, the value index I authored for Medicare payments remains in the bill, " said Klobuchar.

The MMA has been a strong supporter of Klobuchar's effort to require that a "value index" be established as a method for paying physicians treating Medicare enrollees. The MMA supports the measure, since Minnesota physicians, who receive relatively low Medicare payments compared to other states despite providing high-quality care, should benefit from such a payment change.

The change to the Medicare payment system would be administered, beginning in 2012 by the Secretary of Health and Human Services.

The Secretary would work to establish uniform definitions for quality that would form the basis for the index. The proposal is budget neutral and would take into account justifiable differences in Medicare spending. It is not contingent on a study as is the House proposal.

"We have been saying from the beginning that lawmakers should not miss this chance to address Medicare payment reform and geographic payment disparities," said Dave Renner, the MMA's director of state and federal legislation.

Earlier this month, the MMA voiced its continued support for the value index, despite the AMA's announcement that it did not support the measure. 

Proposed Value Index Timeline
2012 - Specific cost and quality measures published
2013 - Implementation of value-based adjustment process begins
2015 - Payment consequences begin
2017 - All physician payments subject to payment modifier.