Today U.S. Congressman Sam Johnson (3rd Dist.-Texas) delivered the following opening statement at a hearing titled, “Examining Pay-for-Performance Measures and Other Trends in Employer-Sponsored Health Care.” Johnson chairs the Employer-Employee Relations Subcommittee on the Education and the Workforce Committee.
Today U.S. Congressman Sam Johnson (3rd Dist.-Texas) delivered the following opening statement at a hearing titled, “Examining Pay-for-Performance Measures and Other Trends in Employer-Sponsored Health Care.” Johnson chairs the Employer-Employee Relations Subcommittee on the Education and the Workforce Committee.
The hearing explored efforts by employers and health insurers to reward doctors and hospitals for delivering high quality results for patients, rather than paying them the same amount regardless of how well they deliver services to patients.
According to the Committee on Education and the Workforce, several well-publicized studies by the Institute of Medicine (IOM) have identified significant gaps and variations in the quality and safety of health care patients receive and have revealed a startling gap between what science suggests medical practitioners should do and what they actually do. This suggests that relevant and meaningful information fails to reach many clinicians and patients. For example, recent studies have found that preventable medical errors were not uncommon.
In recent years, employers and insurers have sought to address concerns raised by the IOM reports, including developing incentive systems that are commonly known as pay-for-performance. Under these plans, employers and insurers commonly offer incentives to doctors and hospitals that use better technology and abide by clinical standards. The hearing will focus on these pay-for-performance measures and review the latest evidence on whether it results in improving health care services offered to patients.
“GOOD AFTERNOON. THANKS FOR BEING HERE TODAY.
“EMPLOYERS SERVE AS THE BACKBONE OF HEALTH INSURANCE IN THE UNITED STATES, VOLUNTARILY PROVIDING HEALTH COVERAGE TO NEARLY TWO-THIRDS OF AMERICANS WITH HEALTH INSURANCE UNDER THE AGE OF 65.
“WITHOUT THEIR COMMITMENT TO KEEP THEIR EMPLOYEES HEALTHY, THE POPULATION OF UNINSURED WOULD SURELY CHANGE DRAMATICALLY.
“THIS MORNING’S HEARING WILL FOCUS ON WAYS THAT EMPLOYERS ARE MOVING – AND IN SOME CASES DRAGGING – THE HEALTH CARE INDUSTRY INTO THE 21ST CENTURY.
“THE FACT IS, EVEN WITH ALL OF TODAY’S TECHNOLOGY, ALL TOO OFTEN PEOPLE ARE GETTING THE WRONG CARE AT THE WRONG TIME. MOST OF US
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“HAVE HEARD WHAT THE INSTITUTE OF MEDICINE INFERRED BASED ON AVAILABLE DATA IN 1999: THAT AS MANY AS 98,000 PEOPLE DIE IN HOSPITALS EACH YEAR BECAUSE OF PREVENTABLE MEDICAL ERRORS.
“I CAN’T THINK OF A SINGLE INDUSTRY WHERE IT’S A STANDARD BUSINESS PRACTICE TO PAY THE SAME RATE TO PEOPLE WHO PROVIDE GOOD SERVICES AND PEOPLE WHO PROVIDE BAD ONES.
“BUT THAT IS THE WAY THE GOVERNMENT AND OTHER PURCHASERS OF HEALTH CARE DO BUSINESS – WHICH DOES NOT PROVIDE MUCH OF AN INCENTIVE TO IMPROVE YOUR CARE.
“SHOULDN’T WE REWARD DOCTORS AND HOSPITALS FOR DELIVERING HIGH QUALITY RESULTS FOR PATIENTS, RATHER THAN PAYING THEM THE SAME AMOUNT REGARDLESS OF HOW WELL THEY DELIVER SERVICES TO PATIENTS?
“SOME INNOVATIVE EMPLOYERS AND INSURERS DECIDED TO DO JUST THAT-- TO BECOME BETTER PURCHASERS OF THEIR HEALTH CARE, AND TO SEEK OUT THE PROVIDERS THAT HAD FIGURED OUT HOW TO INCREASE QUALITY, WHILE KEEPING COSTS AT A MINIMUM.
“OUR WITNESSES TODAY WILL TELL US ABOUT A FEW OF THE PROGRAMS THAT CAME OUT OF THAT DECISION TO BECOME SMARTER SHOPPERS.
“IT IS WORTH MENTIONING THAT THIS MOVE TOWARDS BETTER PURCHASING COMES AT A CRUCIAL TIME IN THE DEVELOPMENT OF CONSUMER-DRIVEN HEALTH INSURANCE PRODUCTS.
“SINCE WE’VE PUT THE SPOTLIGHT ON QUALITY, WE’VE FOUND OUT THAT HOSPITALS THAT SPEND MORE MONEY AREN'T NECESSARILY THE ONES WITH THE HIGHEST QUALITY.
“IN FACT, MORE MONEY IS A PRETTY GOOD INDICATION OF A LACK OF EFFICIENCY. OUR CONSUMERS NEED TO KNOW INFORMATION LIKE THAT IN ORDER TO GET THE MOST OUT OF THEIR ABILITY TO CHOOSE.
“THE BEST THING ABOUT PAY-FOR-PERFORMANCE, THOUGH, IS NOT THAT IT SAVES MONEY. IT SAVES LIVES.
“MEDICARE IS ONE EXAMPLE OF SUCCESS OF IMPROVED QUALITY IMPROVEMENT. MARK MCCLELLAN -- THE MAN RESPONSIBLE FOR MAKING SURE MEDICARE AND MEDICAID ARE WORKING PROPERLY (NOT AN ENVIABLE JOB!) -- RECENTLY ANNOUNCED THAT ALL OF THE 270 HOSPITALS PARTICIPATING IN THEIR PREMIER PAY-FOR-PERFORMANCE DEMONSTRATION PROGRAM REPORTED IMPROVED QUALITY OF CARE -- AND THAT’S JUST IN THE FIRST YEAR.
“TODAY WE WANT TO HEAR FROM A FEW OF THE PIONEERS OF PAY-FOR-PERFORMANCE AND FIND OUT WHAT YOUR EXPERIENCE HAS BEEN--INCLUDING ANY PREDICTED OR UNFORESEEN CHALLENGES THAT YOU’VE FACED.”
