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Priorities for Government Action in Health Reform


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Participants at the Mayo Clinic National Symposium on Health Care Reform gathered in three groups to develop key actions steps for government.

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Priorities for Government Action in Health Reform

  1. 2. Moving Reform Forward Together Cross-sector Breakout Sessions March 11, 2008
  2. 3. Breakout Group 1 Session Results <ul><li>Mandate universal coverage – should be affordable and based on income, but have choices, with no pre-existing condition exclusions – every citizen should have coverage, penalty if you don’t </li></ul><ul><li>Congress should direct Medicare to pay for value </li></ul><ul><li>President/federal government should set three goals: universal coverage; EMR; reduce preventable adverse events by 50 percent (within four years) </li></ul>
  3. 4. Breakout Group 1 Session Results <ul><li>Congress should promote equitable reimbursement for primary care providers and further promote value of primary care </li></ul><ul><li>President should endorse four Mayo Clinic Health Policy Center cornerstones as basis for legislation (no commission) </li></ul>
  4. 5. Breakout Group 2 Session Results <ul><li>Assure coverage for all </li></ul><ul><li>Require all providers to have interoperable electronic medical records by date certain </li></ul><ul><ul><li>VA system as possible default </li></ul></ul><ul><ul><li>Provide tax credit </li></ul></ul><ul><ul><li>Incentives for those who use system </li></ul></ul><ul><ul><li>Consultants to defray costs </li></ul></ul>
  5. 6. Breakout Group 2 Session Results <ul><li>Implement an independent “Federal Health Reserve” to </li></ul><ul><ul><li>set rules/standards to promote value in healthcare (for example):Care coordination </li></ul></ul><ul><ul><li>Define basic benefits package </li></ul></ul><ul><ul><li>Make rules and establish standards </li></ul></ul><ul><ul><li>Data requirements </li></ul></ul><ul><ul><li>Refine standards and best practices </li></ul></ul><ul><ul><li>Reduce waste/inefficiencies </li></ul></ul><ul><ul><li>Facilitate inter-agency participation in reform </li></ul></ul><ul><ul><li>Define a national risk pool </li></ul></ul><ul><ul><li>Promote reimbursement based on wellness </li></ul></ul><ul><ul><li>Guarantee portability of healthcare insurance </li></ul></ul>
  6. 7. Breakout Group 2 Session Results <ul><li>Reform Medicare: </li></ul><ul><ul><li>pay for outcomes/value </li></ul></ul><ul><ul><li>eliminate geographical disparities </li></ul></ul><ul><ul><li>remove policies that penalize individual patients </li></ul></ul><ul><li>Promote individual-based insurance as an option along with employer-based insurance </li></ul>
  7. 8. Breakout Group 3 Session Results <ul><li>Direct HHS to mandate health IT interoperability within five years and tie reimbursement to it (don’t implement mandated standard - no payment). Records are accessible to patients. </li></ul><ul><li>CMS should devote part of rewards to adapt and support health IT infrastructure that protects patient privacy . </li></ul><ul><li>CMS reimbursements should be aligned with outcomes and incentives should be created for preventive care. </li></ul>
  8. 9. Breakout Group 3 Session Results <ul><li>Congress should pass universal access, either by individual mandate or Medicare expansion which would require mandated guaranteed issue, open enrollment, community rated, portable, health insurance (preventive and chronic care) for individuals. </li></ul>
  9. 10. Breakout Group 3 Session Results <ul><li>Create a national center (public/private partnership) for evidence-based medicine and management of evidence-based medicine to: </li></ul><ul><ul><li>Define episode of care using evidence-based medicine standards </li></ul></ul><ul><ul><li>Characterize a range of appropriate care for each high cost medical condition </li></ul></ul><ul><ul><li>Define clinical excellence outcomes and tie to reimbursement </li></ul></ul><ul><ul><li>Ensure nationwide use of evidence-based data </li></ul></ul><ul><ul><li>Examine international best practices and promote incorporation in U.S. </li></ul></ul>
  10. 11. Breakout Group 3 Session Results <ul><li>CMS should change reimbursement structure to: </li></ul><ul><ul><li>promote demonstration projects such as reimbursement for illness episodes </li></ul></ul><ul><ul><li>bundle payments </li></ul></ul><ul><ul><li>pay for performance </li></ul></ul><ul><ul><li>standardized claim processing </li></ul></ul><ul><ul><li>require electronic prescribing </li></ul></ul><ul><ul><li>avoid duplicative capital expenditures </li></ul></ul><ul><ul><li>retain savings for coverage expansion </li></ul></ul>