Jeff Bingaman United States Senator from New Mexico

WASHINGTON - U.S. Senator Jeff Bingaman has introduced legislation that takes a bold step toward helping reform the country’s heath care system.

Bingaman is the author of the Medicare Quality and Payment Reform Act of 2009, which makes crucial reforms to the Medicare program to ensure higher quality and more effective health care for Americans.

Under the current payment system, which focuses on paying per procedure, little is done to incentivize the highest quality and most efficient care possible.

Bingaman’s bill would require the U.S. Department of Health and Human Services (HHS) to work with Medicare providers to analyze and incentivize higher quality and more efficient care.  It also would establish a voluntary program to allow for the “bundling” of payments for episodes of care, which many experts believe will maximize quality and efficiency for Medicare patients while bringing heath care costs down.

“The changes made by this legislation have the potential to improve the care provided to Medicare patients, while lowering overall healthcare costs,” Bingaman said.

 Reforms such as these have been recommended by the non-partisan Medicare Payment Advisory Commission (MedPAC), the Commonwealth Fund and many other experts.  In its December 2008 Budget Options report, the Congressional Budget Office (CBO) estimates that reforms such as these could result in more than $28 billion in savings to the federal government over 10 years. 

Specifically, the legislation would require HHS to:

• Provide a report on readmission rates and resource use to Medicare providers;
• Establish benchmarks based upon these data, that over time, will be used to adjust Medicare payments.  In analyzing payment levels and determining what tests and treatments are appropriate, HHS must take into account the overall health status of the patient or other factors that influence health care needs.
• Institute a voluntary pilot program, which would replace the current fee-for-service payment system with bundled payments for certain high cost and high volume services.  These payments would encompass the cost of an entire patient care episode over a set period of time (e.g., 30 days).