Gov. Pawlenty Heads Down “Big Government” Path for Health Care Reform (HF 3391) - CCHC analysis of 4/30/08 proposal from the Governor’s Office
Price Fixing & Rationing of Care
Compliance Payments - Government-developed all-state payment system to “link the level of payments to providers to the quality of care.”
No Definition of Quality – The term “quality” is not defined, and could include limiting access to care.
Violates Patient-Doctor Relationship – This pay-for-performance (pay-for-compliance) incentive payment is provided according to outside scoring of “quality”.
Not Quality - Quality “indicators” include compliance with data collection & reporting of private medical data and cost information. Is that "quality"??
Measuring Doctors. - Payment incentive programs will “reward high-quality, low-cost providers.”
Incentive to Ration - Health plans allowed to “reduce or reallocate payments to other providers” to pay more to high-quality providers
Government System - Government establishes a “care coordination” payment system for all patients statewide.
Price Controls - Government “shall establish uniform definitions for baskets of care.” Voluntary...at least at first.
Violation of Privacy Rights
No Consent - private patient data distributed en masse to “a private entity” without consent.
Easy Outside Access to Data – Centralized authority to control the make-up of all online electronic medical records.
Electronic Prescribing Required – Whether they use it or not, all doctors, prescribers, and health plans must establish electronic prescribing.
Federal Control - Puts electronic prescribing under the HIPAA “no privacy” Rule – doesn’t allow stronger state privacy laws to take effect.
Tracking Patients and Doctors – data reporting requirements for health care homes, payment reform, and “quality” scoring
Child Body Mass Index scoring permitted (does not include Rep. Holberg’s prohibition language)
Government Controls
Government Score Cards - Health care providers scored according to the government’s definitions of “cost of care, resource use, quality of care.”
Managed Care for All – standards for a restrictive statewide managed care model—“Health Care Homes”—to be established for use by private and public sector. No public comment allowed.
Control by Bureaucracy
- Health Care Home Collaborative
- Certification Commission for Healthcare Information Technology
- “Private Entity” – payment incentives
- “Private Entity” – care coord. payments
- “Private Entity” – transparent pricing
- “Private Entity” – calculate costs/quality
- Workgroup – claims adjudication
- Working Groups – reforming payment
- Advisory Group – cost/quality information
- “Private Entity” – collect quality info.
- Workgroup – define “baskets of care”
- National Accrediting Organization
Unfunded Mandates/Added Costs
- Data collection and reporting mandates
- Working groups staff/”Private Entity” contracts
- Statewide Health Improvement Program - $$$$$ (millions)
- Electronic prescribing/ electronic medical records requirements