January 26, 2015

New Obama Administration Goals for Medicare Mirror Sen. Whitehouse Recommendations

Senator Whitehouse has Been Urging Administration for Years to Set Clear Goals to Improve Care and Reduce Costs

Washington, DC – Today the Obama Administration announced that it is setting clear goals and a specific timeline for reforming the way doctors and hospitals are reimbursed when treating Medicare patients.  The goals announced today come after U.S. Senator Sheldon Whitehouse (D-RI) has been urging the Administration for years to set clear targets for health care delivery system reforms, arguing as early as 2011 that, “we can and must have a clear challenge to strive toward.”

In 2013 Whitehouse co-authored an opinion piece urging President Obama to set specific goals for reforming payment systems, noting that “at least 75 percent of Medicare payments should be assessed in some way other than fee-for-service” by 2020.  Whitehouse also released a report in 2012 chronicling the Administration’s progress in implementing the delivery system reform provisions within the Affordable Care Act, and identifying payment reform as one of five key areas for reform.

“As we continue working to improve the delivery of care and lower costs in our health care system, it’s vital that we set clear, accountable goals,” Whitehouse said today.  “Vague calls to ‘bend the cost curve’ will never galvanize our nation’s health care providers and insurers in the same way that specific goals with a number and date will.  Today’s announcement by the Obama Administration reinforces the reforms already taking place under the Affordable Care Act and could accelerate the shift to a system that works better for everyone.”

More specifically, the U.S. Department of Health and Human Services (HHS) today set a goal of tying 30 percent of traditional fee-for-service Medicare payments to alternative payment models by the end of 2016, and tying 50 percent of payments to these models by the end of 2018.  HHS also set a goal of tying 85 percent of all traditional Medicare payments to quality or value by 2016 and 90 percent by 2018.  Whitehouse was briefed by HHS Secretary Sylvia Mathews Burwell in advance of today’s announcement.

Since 2011, Senator Whitehouse has been calling on the Administration to set a specific cost-savings target to drive health care delivery system reform efforts, and has identified payment reforms as one of the key areas in any such effort.  More recently, he and Rhode Island Foundation President Neil Steinberg brought together a coalition of Rhode Island health care leaders to develop recommendations on how the state can improve care and lower costs.  Among the recommendations they agreed to was to establish specific payment reform goals this year.

Senator Whitehouse has long been a leading voice for health care delivery system reforms.  He founded the Rhode Island Quality Institute during his time as the state’s Attorney General, helped secure new investments in Health Information Technology in the American Recovery and Reinvestment Act, and was a strong advocate for the inclusion of delivery system reforms in the Affordable Care Act. 

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Meaghan McCabe, (202) 224-2921
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