Aside from a few key differences, the healthcare reform bill set for a Saturday vote in the Senate contains essentially the same provisions supported by provider groups in the House version.
Projected by the Congressional Budget Office at $849 billion, the Senate bill shares several components of its House counterpart, such as a national pilot program to test the effectiveness of bundled payments and creation of Accountable Care Organizations to test new approaches for managing population health.
It also includes a budget-neutral expansion of the hospital value-based purchasing program that was removed from the House bill at the last minute, said Blair Childs, senior vice president of public affairs for San Diego-based Premier.
The hospital membership organization strongly supports these measures, Childs said, along with the creation of an independent comparative effectiveness research institute and disclosure of payments of value to physicians.
"Together, these reforms will more appropriately align payment incentives and increase transparency, improve quality, reduce care variation and avoid unnecessary healthcare costs," he said.
While American Hospital Association and Medical Group Management Association representatives said the groups were still reviewing the 2,000-page legislation Friday morning, both have gone on record as supporting many of the House provisions contained in the Senate version.
That doesn't mean there aren't concerns. After passage of the House bill on Nov. 8, AHA President and CEO Rich Umbdenstock voiced reservations about whether the reform program would be based on "historically low" Medicare rates and questioned expanding Medicaid eligibility to 150 percent of the federal poverty level when states are struggling with budget shortfalls.
Both the AHA and Premier have come out against penalizing hospitals for patient readmissions and a $20 billion medical device manufacturer tax that can be passed on to hospitals.
"The Senate finance draft was consistent with the position we have been advancing – a reduction in payment for hospital readmissions within seven to 15 days of release," Childs said. "But the current Senate draft has a 30-day readmission policy. At that point the patient's condition is largely beyond the hospital's control."
On the taxation issue, Childs said the Senate version is more palatable because it is based on gross receipts as opposed to an excise tax on every device.