Health Reform Must Focus on Quality of Care

America needs a new health care system that provides more choices, lower costs, better care and more coverage — but we must change the way we pay for it. We must focus on the value of care versus the volume of care if we want to control costs and encourage doctors to provide the best care at a price we can afford. I am pleased that the Affordable Health Care for America Act took steps to do just that.

Studies show that close to 30 percent of all health care spending each year, approximately $700 billion, goes to treatment and procedures that do not improve patient care. The over-utilization of health care drives up prices, has little value to patients and can actually lead to worse results. A system focused on the value of care will transform our health care system and will lead to better results at a lower cost.

To achieve this, we don’t need to ration care, but rather empower health care professionals to practice evidence-based medicine, determining what care works and what doesn’t and focusing on providing the most effective care. As much as $850 billion spent on medical care each year can be eliminated without reducing the quality of care, according to a <a href="http://nehi.net/uploads/full_report/waste__clinical_care_report__final.pdf">2008 report</a> by the New England Healthcare Institute. Through comparative effectiveness studies and health information technology, we can bridge the information gap, allowing providers to better and more easily determine the kind of care patients have had, eliminate unnecessary care and deliver quality care to meet their needs.

I led the way to include value as a component of Medicare reimbursement in the House health care reform bill. This effort is particularly historic because it is the first major reform to the Medicare system that pays providers based on the quality of care they provide, transforming our health care system to one that puts quality before quantity, keeps our best interests in mind and keeps costs under control. I know these reforms can work because the providers in western Wisconsin have long been delivering high-quality, low-cost care that has been looked to as a national model.

For too long, these providers have been reimbursed at rates that don’t reflect the quality of care they deliver. This provision changes that and also helps prevent the cost shift that occurs when private insurers have to pay for uncompensated care to the uninsured, passing along costs to those with private insurance. In the long run, it cuts premium costs.

The bill requires the Institute of Medicine to make recommendations for fixing the current flawed Medicare reimbursement system. Following a study, IOM will provide recommendations on changing the Medicare payment system to reward value and quality, value being defined as the efficient delivery of high-quality, evidence-based, patient-centered care. Recommendations will be ready for implementation before the national exchange or public insurance option goes into effect.

A value-based reimbursement system benefits all states and all regions — it provides the kind of care patients need and can afford, versus as much care as they can afford, providing benefits and reducing risks associated with overuse of the health care system. Americans deserve providers that know what works, health care that heals and prices that are reasonable. If we want a system that gives us more than we currently get without breaking the bank, we must put a greater emphasis on value-based medicine and on the quality of care provided. We must reform our current health care system.

Rep. Ron Kind (D-Wis.) serves on the Ways and Means Committee, one of three House committees with jurisdiction over the House health care reform bill.

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