Braley announces commissioning of Medicare study

Goal is to end geographic disparities in reimbursement that have punished Iowans for decades

A study on geographic disparities in Medicare reimbursement that Iowa congressmen say shortchange the state's health care providers has been commissioned by the Department of Health and Human Services.

The commissioning is “an important step in finally changing the way Medicare does business,” according to 1

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District Rep. Bruce Braley. He and other members of the Iowa delegation believe the study, the first of two by the Institute of Medicine Studies, will help move Medicare to a quality-based reimbursement system.

A report by the Commonwealth Fund late last year found Iowa health-care providers deliver patient outcomes second only to their counterparts in Vermont. However, providers and state officials have argued Iowa's low reimbursement rate – lower than payments to providers in 48 other states -- makes it difficult to attract and retain health-care providers. That can compromise patient care.

In a meeting at the Capitol Tuesday, Sebelius announced to Braley and other members of the Quality Care Coalition that she has commissioned the study to evaluate the geographic payment factors that adjust payments for both doctors and hospitals in time for the 2012 payment cycle.

“For decades, Iowa's doctors have been punished for no reason other than geography,” Braley said. “The study announced today will finally evaluate the data and prove what we've known for decades: that Iowa's medical providers offer some of the best care in the nation, but have never been properly reimbursed.”

Braley negotiated a compromise in the health care reform bill that provides an immediate $800 million to address geographic disparities for doctors and hospitals, as well as written guarantees from Sebelius for further action to reform Medicare reimbursement rates that do not qualify for reconciliation under the Byrd Rule. The Senate bill previously only provided a Medicare reimbursement fix for doctors.

The House reconciliation package maintained automatic implementation of a value index as part of the reimbursement structures for doctors, beginning in 2015. This language was secured in the Senate bill with the help of Sen. Tom Harkin and is based on Braley's Medicare Payment Improvement Act, introduced in June 2009. Under the fixes secured in the Senate bill and House reconciliation package, Iowa doctors will see 5 percent increases in current Medicare reimbursement rates in both 2010 and 2011.