Leslie Matthews |
On February 16, the Senate Health & Welfare Committee presented the following outline of proposed or potential pieces of a reform bill this year. Notably, when someone asked about universal coverage, noting the outline seems not to address this major point, the committee replied that the issue of universal coverage was being dealt with in the House Healthcare Committee. Its not clear how meaningful reform will be made without uniting these issues.
The Healthcare is a Human Right policy committee has requested permission to testify about this outline. That testimony is still being prepared. Please contact the Healthcare is a Human Right policy committee if you wish weigh in. Everything below is from the outline from Senate Health & Welfare.
Senate Health & Welfare Committee
2010 Health Reform Bill
The intent of the bill is to reduce the level and rate of growth of health care costs to a more sustainable level through a combination of actions which both
- have an immediate impact on health care costs in FY11 and FY12
- accelerate the structural transformation of the health care delivery and payment system
I. Immediate cost containment options
a. Process involve BISHCA, VAHHS, VMS and health plans
i. Modified hospital budget review with state wide targets for reduced growth for FY11 and FY12
ii. State initiatives to reduce administrative burdens on hospitals to be implemented for FY11
c. Health plans
i. Revised review of premium rate increases
ii. State initiatives for reduced administrative burdens to lower administrative cost and premiums to be implemented for FY11
II. Acceleration of delivery system integration and global budgeting
a. Intent: build on the planned statewide expansion of the Blueprint for Health Enhanced Medical Home and expanded health Information Technology
b. Design: review global budgeting options
i. Geographic scale
3. Hospital service area based
ii. Scope of services
1. Hospital system
2. Hospital and all physicians
3. Comprehensive: e.g. add mental health, prescription drugs, etc.
c. Global budget methodology:
i. who designs and approves global budget
ii. global payment vs. global budget under fee for service
iii. what is the structure of the provider organization and how does it increase integration of care?
iv. estimated savings
1. one time administrative costs
2. bending cost curve
d. Timeline: staged vs. total conversion
i. pilot operations by ?.
ii. at least half the state using global budgeting by ?
iii. state wide implementation by ?
e. All payer participation
i. Existing multipayer system
1. Medicare: file for Medicare waiver
2. Plan for Medicaid participation from OVHA
3. Require participation of all commercial insurers
ii. Shift to single payer first?
i. Accountability and funding for design and implementation
III. Plan to restructure the way we fund health care and move away from current employer based, multi-payer system to a single payer or public option plan
a. Intent/charge: assess specific options for restructuring financing of coverage to reduce administrative cost and burden
b. Accountability: Consultant required for design with panel overseeing work
c. Report to Legislature 1/15/11 including
i. Pro's and con's of options
ii. How much money needs to be raised, how it would be raised
iii. Analysis of who would pay more and who would pay less
iv. Payment system: how the money would be spent
v. Estimated savings
d. Funding for consultant
IV. Reorganization of state government to ensure that all health care related work is coordinate (Sen. Kitchel's bill)
i. Creation of Secretary of Health
ii. what agencies/functions are included
c. Effective date