Harkin sees change in Medicare reimbursement

Sen. Tom Harkin, a veteran of several unsuccessful attempts to improve Medicare reimbursement to Iowa health-care providers, sees the current congressional debate as the best opportunity to reward their high-quality care.

“Now's our chance if we're going to have a big health care reform bill,” Harkin said. He's encouraged Sens. Max Baucus and Iowa Republican Chuck Grassley, the chair and ranking member of the Senate Finance Committee, who are key players in the health-care reform debate, are from rural states. Baucus is a Montana Democrat.

He hasn't seen any movement on changing Medicare reimbursement, “but we haven't seen a bill yet from the Finance Committee.” He's confident Baucus and Grassley will address the topic.

“I've spoken to both of them about that and I have every reason to believe that they're going to fix it,” Harkin said in his weekly conference call with Iowa reporters. Grassley has long advocated a reimbursement system that rewards the value and efficiency of health-care providers' service.

Although Medicare has found the quality of health-care delivered by Iowa providers to be among the best in the nation, Iowa has consistently ranked low – currently 49

^th

– among the states in reimbursement. Iowa lawmakers at both the state and national level have argued that makes it difficult to attract and retain health-care professionals who can earn more in other states.

In the U.S. House, Iowa representative say they scored a breakthrough on the issue with a compromise calling for Medicare to begin paying health-care providers on a quality-based system beginning in 2012, after a two-year study by the Institute of Medicine. That should increase reimbursement to Iowa providers, they say.

The current Medicare reimbursement system bases payments to doctors and hospitals on the amount of procedures completed and the number of patients seen, Iowa congressmen said. That creates a financial incentive to order more procedures, which, they said, does not result in better outcomes for patients.

Harkin has expressed frustration with the slow pace of health-care reform in the Senate. With the Finance Committee saying its bill probably won't be available for a vote before the August recess, the process has been delayed by a month, Harkin said.

“This isn't easy, he said. A lot of interests “have fingers in the pot and they don't want to change the system.” However, Iowans are telling him the status quo is not working.

He also questioned suggestions by Budget Committee Chairman Kent Conrad, D-N.D, that there are not 60 votes in the Senate for a public insurance option.

“It depends on what's in the bill,” Harkin said. “There's a lot of trading going on.”