The health reform package being crafted in Congress could include Medicare payment bonuses to primary care physicians and general surgeons, according to policy options released by leaders of the Senate Finance Committee.
The 52-page paper is a first look at the proposals on the table in this year's health reform debate. But these proposals are just a starting point, according to Sen. Max Baucus (D-Mont.), chairman of the Senate Finance Committee, and Sen. Chuck Grassley (R-Iowa), the committee's ranking member. They said they will be seeking comment from the public and other members of Congress before developing more concrete proposals.
Among the options under consideration is a proposal to boost payment to primary care physicians and general surgeons working in certain rural areas. Under the proposal, these physicians would receive a Medicare payment bonus of at least 5% for 5 years. But since the proposal is budget neutral, at least part of the funding would come from an across-the-board payment cut for other non-primary care services, according to the Senate Finance Committee document.
The Finance Committee's policy paper also includes a proposal to bundle payments for acute hospital care and post-acute services. Under that proposal, Medicare would begin in October 2014 to provide a single, bundled payment for acute hospital services and post-acute services that occur within 30 days of discharge. The post-acute payments affected by the proposal would be those made to home health care, skilled nursing facilities, rehabilitation hospitals, and long-term care hospital services. Under the proposal, the bundled payment would be phased in starting with conditions that account for the top 20% of post-acute spending.
The paper also includes proposals to expand the Medicare pay for the Physician Quality Reporting Initiative (PQRI). Under the policy proposals being considered, physicians involved in the program would also be eligible to earn bonus payments for participating in a qualified Maintenance of Certification program and a related practice assessment.
The policy options paper is the first of three sets of such documents that will be released before the committee's markup of comprehensive health reform legislation this summer.