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Federal Update

Federal Update. December 3, 2009. Congressional Activity on Reform. House Approved reform bill on November 7. Senate Currently debating bill. Process. Option 1. Option 2.

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Federal Update

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  1. Federal Update December 3, 2009

  2. Congressional Activity on Reform

  3. House Approved reform bill on November 7 Senate Currently debating bill Process Option 1 Option 2 Alternatively, a bill approved by either chamber could be “ping-ponged” between each chamber until an identical bill is passed by both.

  4. Critical Issues in Play

  5. Comparing Reform Proposals

  6. Coverage Expansion

  7. Coverage Expansion–How?

  8. Includes surtax on high income taxpayers and tax on device manufactures. House: Cost = $1.052 trillion. Fully offset over ten years. * Senate: Cost = $848 billion. Fully offset over ten years. * Major Financing Components * Reflects gross cost of coverage expansions based on CBO scores.

  9. House: $258 billion over ten years. Senate: $244 billion over ten years. Hospital and Health System Reductions House and Senate are generally consistent on the level of hospital cuts, with approximately $155 billion in Medicare and Medicaid reductions over ten years.

  10. Key Hospital and Health System Provisions

  11. Medicare Update Factor Reductions

  12. DSH Reductions

  13. Hospital Readmissions

  14. Hospital Value-Based Purchasing

  15. Geographic Variation

  16. Wage Index

  17. Graduate Medical Education

  18. Independent Medicare Advisory Board

  19. 340B Drug Discount Program

  20. State Fiscal Relief

  21. Key Hospital and Health System Pilots and Demos

  22. Medicare Payment Bundling

  23. Accountable Care Organizations

  24. Medicaid Payment Demos

  25. Center for Medicare and Medicaid Innovation

  26. Additional Provisions in Both House and Senate Bills

  27. Additional Provisions in Senate Bill Only

  28. Key Issue Not Addressed in Reform: Medicare Physician Payment Cut

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