Baucus talks up health reform

Sen. Max Baucus (D-Mont.) believes there's never been a better time for major healthcare reform -- and as chairman of the Senate Finance Committee, Baucus has a major say in shaping the legislation for such a reform. I represented Part B News at a March 3 breakfast meeting with the senator, sponsored by the Kaiser Foundation and aimed at giving health reporters access to key players in the reform effort.

You can watch a video of the complete meeting, including a lengthy Q&A session where I ask Baucus a question, by clicking here.

The focus of reform is to update office technologies nationwide while shifting the payment paradigm to reward providers based on quality of care, Baucus said.

"It's time to move from first steps to giant steps, it's time to charge forward on comprehensive healthcare reform," he said. "The stars are all aligned. In addition the president is firmly committed to reforming our healthcare system."

Reform efforts will be centered around health care delivery that aligns payments with value, Baucus said. A reformed delivery system would include value-based purchasing and several major CMS initiatives already underway. "Health [information technology] is part of it, comparative effectiveness is part of it," he said. Patient-centered medical homes and bundled payments for facilities would also be part of the new delivery system, he said.

Doctors could be third in line for cuts
Baucus said he wants the reform bill to address the 21% Medicare physician pay cut slated for 2010, but seasoned politicos say healthcare reform may end up cutting health care payments across the board, though not nearly as much as 21%. 

Reductions to provider payment, including physicians, is one possibility to pay for the $634 billion healthcare reform budget (PBN 3/2/09), says Ellen Kugler, a longtime healthcare lobbyist and current executive director of the National Association of Urban Hospitals in Washington. "If they can't get the savings they want from other sources, like by cutting pharmaceutical coverage or Medicare Advantage payments, then the only other place to look is providers."

(continued next week)