Column: Reward quality health care

It's just one part of the sprawling, 1,990-page health care reform bill House Democrats unveiled last week.

But proposed changes in Medicare reimbursements could make a huge difference for Iowa's health care providers.

Right now, we're second-to-last among states in Medicare reimbursements per beneficiary.

We've been at the bottom of the pile for years, partly because our system does such a good job of keeping people well.

A recent Commonwealth Fund study found Iowa is second only to Vermont in terms of health care access, prevention and treatment, potentially avoidable hospital use and costs, and population health.

But while our Grade A system is relatively good for patients, it's not always so attractive for providers: Medicare's current fee-for-service payment structure actually rewards inefficient and ineffective care.

“Were not paid to help people avoid health care. We're paid to have people use us more,” Iowa Health System President and CEO Bill Leaver said when he and St. Luke's Hospital CEO Ted Townsend met with us Thursday to talk about health care.

You don't have to be an expert to see that's a pretty good place to start when you're looking for ways to control health care costs.

Townsend called the current model a “reimbursement treadmill” that keeps doctors from helping patients manage their health.

Docors are paid to look you over and write a prescription, he said, but they're not paid to make sure you understand what you're supposed to do next.

They're not rewarded for eliminating waste. They're not rewarded for helping keep you out of the hospital.

The Affordable Health Care for America Act could finally change that. It calls for a two-year study to figure out a new outcomes-based payment system for Medicare, which would automatically go into effect unless the House and Senate pass joint resolutions to stop it.

A second study would get to the bottom of geographic payment inequities - something Iowa's elected officials have been trying to change for years.

That's great news, because even lean, mean Iowa has room for improvement. Leaver and Townsend talked about using fiber-optic networks to expand tele-health services and using call centers to help patients manage chronic conditions.

Good ideas. Let's hope legislators make it worth their while to implement them.

Jennifer Hemmingsen's column appears on Wednesdays and Saturdays. Contact the writer at (319) 339-3154 or jennifer.hemmingsen@gazcomm.com