To:The Honorable Mark BegichThe Honorable Michael BennetThe Honorable Roland BurriThe Honorable Kay HaganThe Honorable Ted KaufmanThe Honorable Paul Kirk The Honorable Jeff MerkleyThe Honorable Jeanne ShaheenThe Honorable Mark UdallThe Honorable Tom UdallThe Honorable Mark Warner From:CEO Work Group for Health ReformWe represent CEOs from a wide range of healthcare delivery, payer and vendor organizationsthat will have to work together to implement the payment and quality reforms envisioned by theframers of the pending legislation. We recognize the profound opportunity afforded our countryat this juncture in the current debate. As a result, we enthusiastically endorse the general thrust of the Patient Protection and Affordable Care Act and specifically the amendments now proposed byyour upcoming amendments.The waste and ineffectiveness of the current healthcare system do not derive frommismanagement or malfeasance, but rather from a hodgepodge of payment and regulatory forces, built over decades, that have resulted in perverse financial incentives and obstacles to efficient,effective care.While the power to address these problems at a systemic level rests with Congress, we haveworked within our own organizations to improve outcomes while reducing costs. We and othersin the industry have endeavored to better coordinate the disparate elements of care, improvedecision-making with evidence-based clinical practice, and share best practices betweenorganizations. We have come together as a Health Reform Work Group to advance our commoninterest in seeking the payment and regulatory changes that can enable us to more effectively provide sustainable, quality care as partners across the broad continuum of provider types, payersand key vendors to the industry.But there is a limit to how much progress can be made in the current environment, in whichdoctors and hospitals are rewarded for doing
somethin
g rather than for doing the
right thing
in the
right setting
. The proposed amendments will strengthen the Senate bill through the creation of additional economic and regulatory incentives to transition the many thousands of separate andindependent players that comprise the U.S. healthcare system—large multi-hospital systems,local physician practices, ambulatory surgical centers, home health providers and others—towardan integrated, quality-oriented system by:
Promoting and Accelerating Delivery System and Payment Reform.
The proposedamendments provide greater flexibility in the design of innovative system structures andimproved analytics and reward systems. This flexibility will accelerate the adoption of newmodels of integrated, risk-based care. While subsequent regulatory refinements will beneeded as health care delivery evolves from an event-based to a value-based payment system,we believe the proposed amendments represent an invaluable start in a process that willultimately provide Americans with improved health care at significantly lower cost.
Strengthening the Independent Medicare Advisory Board.
Authorizing comprehensivehealthcare improvement subject to an up-or-down Congressional vote, rather than the currentitem-by-item approval, will facilitate forward progress without excessive consideration of private economic interests. Enabling the board to make advisory, non-bindingrecommendations across both public and private insurance systems will stimulate moreconsistent, even-handed strategies across the entire system, thereby reducing cost-shifting andexcessive cost reduction pressures on the public programs.
Administrative streamlining.
Standardizing the many interactions between providers and payers will significantly reduce overhead costs, while the increased use of electronic data platforms will reduce errors and allow for the information exchange necessary for shared risk.
Elimination of legal barriers.
Requiring the GAO to identify regulatory barriers toinnovation and the sharing of risk and information between organizations is essential for realreform to occur and will help create an environment of continual improvement.(Attached please find a longer white paper addressing the thinking of our group.)
Signatories
David L. BerndChief Executive Officer Sentara Healthcare Norfolk, VAOffice: (757) 455-7070William BorneChief Executive Officer Amedisys, IncBaton Rouge, LAOffice : (225) 298-3501 Neil Kurtz, M.D.Chief Executive Officer Golden LivingFt. Smith, AK Office: (202) 434-0509Robert Bessler, M.D.Chief Executive Officer Sound Physicians, Inc.Tacoma, WAOffice: (253) 284-1865Martin Hickey, M.D.President & Chief Executive Officer Alegent Health ClinicOmaha, NEOffice : (402) 343-4411Jack Lewin, M.D.Chief Executive Officer American College of CardiologyWashington, D.C.Office: (202) 375-5403Mobile: (202) 262-6608
Gene Lindsey, M.D.Chief Executive Officer Atrius HealthBoston, MAOffice: (617) 559-8260Mobile: (781) 799-7887Michael R. MersonChair of the BoardCareFirst of MarylandOwings Mills, MDMobile: (410) 409-9295Lynn NicholasChief Executive Officer Massachusetts Hospital AssociationBoston, MAOffice: (781) 262-6001David SchmidtChief Executive Officer SCAN Health PlanLong Beach, CAOffice: (562) 989-8310Mobile: (310) 739-2100Steven Strongwater, M.D.Chief Executive Officer Stony Brook University HospitalStony Brook, NYOffice: (631) 444-2701Paul VivianoChief Executive Officer Alliance HealthCare Services Newport Beach, CAOffice: (949) 242-5301Robert Margolis, M.D.Chief Executive Officer HealthCare PartnersOffice: (310) 354-4221Edward G. Murphy, M.D.Chief Executive Officer Carilion ClinicRoanoke, VAOffice: (540) 981-7831Mobile: (540) 520-3887Richard Noffsinger Chief Executive Officer Anvita HealthSan Diego, CAOffice: (858) 554-1886 x 326John H. ShortChief Executive Officer RehabCare Group, Inc.St. Louis, MOOffice: (314) 863-7422Joseph SwedishChief Executive Officer Trinity Health Novi, MIOffice: (248) 489-6792Mobile: (248) 207-3613 Nicholas Wolter, M.D.Chief Executive Officer Billings ClinicBillings, MTOffice: (406) 238-2609