Home Health & Hospice Week

Information technology another topic likely to see legislative action.

The powerful American Association for Retired Persons has come out in support of pay-for-performance legislation. If overwhelming support in the House and Senate wasn't enough to guarantee passage of a P4P bill, then the AARP's boost could seal the deal.

Senate Finance Committee Chair Charles Grassley (R-IA) introduced the Medicare Value Purchasing (MVP) Act of 2005 with co-sponsor Sen. Max Baucus (D-MT) (see Eli's HCW, Vol. XIV, No. 24).

The Grassley-Baucus bill is "an idea whose time has come," says John Rother, the AARP's executive officer for policy and strategy. Using payment incentives to improve performance will spell better care for older and disabled Americans, he adds.

Many lawmakers believe P4P is "the next step in introducing market-based reform and incentives into the Medicare program," says attorney William Sarraille with Sidley Austin Brown & Wood in Washington. "Pay for performance is an idea that will take root," despite resistance from providers, predicts Sarraille.

P4P legislation is likely to open the door to other Medicare-related measures, experts predict. Legislation aimed at boosting information technology seems likely to have a place in any Medicare reform bill, say Washington insiders.

Sen. Mike Enzi (R-WY), chairman of the Health Education Labor and Pensions (HELP) committee, has introduced the "Healthcare Information Technology Quality and Improvement Act of 2005," with ranking member Sen. Edward Kennedy (D-MA). The bill would require health IT systems to work with all other systems, and authorize a national health IT contractor and a "Best Practices Center." The Enzi-Kennedy bill also would provide grants to help providers move to health IT systems.
The Grassley-Baucus P4P bill also calls for a three-year, six-site demonstration project on health IT, aimed at determining the "threshold" amount of IT that providers need in order to collect quality data and use it to improve care for Medicare beneficiaries.   Talking with a nursing home resident's doctor about hospice can boost hospice utilization, says a new study in the Journal of the American Medical Association. Researchers identified a group of residents in three U.S. nursing homes who were appropriate for palliative care, then contacted half of their physicians to authorize a hospice information visit, the JAMA study says.

Residents whose physicians were contacted were more likely to elect hospice care, had fewer acute care admissions and spent fewer days in an acute care setting, according to the study. And those residents' families "rated the resident's care more highly than did families of usual care residents," the study says.

More information is in the July 13 issue of JAMA at http://jama.ama-assn.org.
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