WASHINGTON,
DC – Senators Jeff Merkley (D-Ore.), Amy Klobuchar (D-Minn.), Byron Dorgan (D-N.D.), Maria Cantwell (D-Wash.),
Russ Feingold (D-Wis.), Al Franken (D-Minn.), Tim Johnson (D-S.D.), Patrick
Leahy (D-Vt.), Jeanne Shaheen (N.H.), Mark Udall (N.M.), Tom Udall (N.M.), and Ron Wyden (D-Ore.)
sent a letter to Senate Majority Leader Harry Reid (D-Nev.) today highlighting their
concerns regarding plans to expand Medicare to Americans between the ages of
55-64 without addressing inequities in current Medicare reimbursement
rates. Such an expansion could exacerbate existing provider shortages in
states that have low reimbursement rates.
Under the current Medicare system, states with more efficient
health care systems are punished with reimbursement rates that lag
significantly behind the rates of other states. Because states with low
reimbursement rates already face a shortage of providers willing to accept
patients on Medicare, an expansion of the program would simply see the same
issue expanded to Americans between the ages of 55-64.
“We
are concerned that a possible final health care compromise may include a
Medicare buy-in program for Americans aged 55-64 without addressing inequities
in the current Medicare reimbursement rates,” the senators wrote. “We
appreciate the rationale underlying the proposed Medicare expansion, but fear
that provider shortages in states with low reimbursement rates such as ours
will make such a program ineffective, or even worsen the problems these states
are experiencing.”
To remedy the situation, the senators urged Majority Leader
Reid to hold on any expansion unless steps are taken to provide incentives for
providers to see more Medicare patients.
The full text of the senators’ letter to Majority Leader Reid
appears below.
###
December 11, 2009
The Honorable Harry Reid
Majority Leader of the Senate
S-221 Capitol Building
Washington, D.C. 20510
Dear Majority Leader Reid:
Thank you for all of the hard
work you and your entire leadership team are doing to advance historic health
care reform legislation. We appreciate the difficult task you are faced with
and stand ready to assist you in facilitating this process. We are concerned
however that a possible final health care compromise may include a Medicare
buy-in program for Americans aged 55-64 without addressing inequities in the
current Medicare reimbursement rates. We appreciate the rationale underlying
the proposed Medicare expansion, but fear that provider shortages in states
with low reimbursement rates such as ours will make such a program ineffective,
or even worsen the problems these states are experiencing.
Our states consistently lag
behind other states on Medicare reimbursement and per capita spending. While
there are provisions in the Senate bill to eventually adjust the geographic
disparities in Medicare, possible improvements to the funding formula, if they
occur, will be years away. We strongly believe that a fundamental way to
achieve the goal of more efficiency in Medicare is to realign the Medicare
payment system to reward health care providers for the quality of care
they deliver, not simply the quantity of services they provide.
We represent states and regions
that have demonstrated true leadership in lowering costs to Medicare while
increasing the quality of care patients receive. The “high efficiency” areas we
represent are known for utilizing integrated health delivery systems and
innovative quality measures to provide Medicare beneficiaries with better
value. Research shows that these efficient delivery practices can save the
Medicare program upwards of $100 billion a year, while also providing beneficiaries
better access to the care they need. Unfortunately, the current Medicare
payment structure penalizes those who provide efficient care, while rewarding
those who order unnecessary tests and services.
Creating a Medicare buy-in
program will exacerbate the existing funding inequity. Medicare is spending
over one-third more for each Medicare beneficiary in some states compared to
ours. The combination of an antiquated payment formula that tends to penalize
rural providers and greater medical efficiency in our states has forced many
physicians to stop accepting Medicare patients or limit the number of Medicare
patients they serve. Increasing the number of Medicare patients under a buy-in
proposal without fixing the Medicare reimbursement rate will further exacerbate
this access problem. To make a Medicare buy-in program successful, it is
critical that we find ways to incentivize providers to see more Medicare
patients.
We thank you for your continued
vigilance in working to move the process forward. We look forward to working
with you towards resolution of this particular problem and passage of historic
health care reform legislation.
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