The House Dems yesterday released their 1,000+ page bill for health care reform called "America’s Affordable Health Choices Act of 2009." It includes positive first steps toward physician payment reform by revising the flawed SGRrrr (sustainable growth rate) formula. To positively improve quality, it would continue funding for the Physician Quality Reporting Initiative (PQRI) through 2012, and provide an appeals process and faster feedback on reports. It also makes some long-overdue improvements to the Medicaid program.

Other Provisions
The bill also would:

• Require all Americans to purchase health insurance or be fined, although those making less than $88,000 annually would be able to get a subsidy.
• Get rid of copays and deductibles for preventative care
• Make it illegal to deny coverage for pre-existing conditions
• Create a public plan
• Raise taxes for the wealthy – as much at 5.4 percent for incomes above $350,000

The bill also promotes testing Accountable Care Organizations, which have proven to be models for high quality, low cost health care. We hope more emphasis will be placed on quality improvement through the use of registries so we can measure our way to success. We also need to stress the importance of the application of physician-developed appropriate use criteria, rather than arbitrary imaging changes.

‘Inaction is not an option’
House Speaker Nancy Pelosi (D-Calif.) said that the House plans to vote on the bill before lawmakers break for August recess. As the details emerge, we look forward to more specifics on the payment reform provisions –- these reforms will be necessary to ensure that the access reforms the bill makes will be sustainable.  Until we completely change the way the U.S. payment system is structured, we’ll never be able to bend the cost curve of health care spending.