ADVISORY

FROM THE COMMITTEE ON WAYS AND MEANS

SUBCOMMITTEE ON HEALTH

Chairman Stark Announces a Hearing on Options to Improve Quality and Efficiency Among Medicare Physicians

House Ways and Means Health Subcommittee Chairman Pete Stark (D-CA) announced today that the Subcommittee on Health will hold a hearing on options to improve quality and efficiency among Medicare physicians.  The hearing will take place at 10:00 a.m. on Thursday, May 10, 2007, in Room 1100, Longworth House Office Building.

In view of the limited time available to hear witnesses, oral testimony at this hearing will be from the invited witness only.  However, any individual or organization not scheduled for an oral appearance may submit a written statement for consideration by the Committee and for inclusion in the printed record of the hearing.

BACKGROUND:

Medicare spending for physician services will likely exceed $60 billion in 2007, more than 14 percent of spending on program benefits.  Spending for physician services has grown considerably in recent years, largely due to the 5.5 percent average annual increase in the number of services provided per beneficiary (volume) and the increase in the average complexity and costliness of services (intensity).  Analyses by the Medicare Payment Advisory Commission (MedPAC) and the Government Accountability Office (GAO) have suggested that some of the higher volume and intensity that drives spending growth may not be medically beneficial.  In fact, the wide geographic variation in Medicare spending per beneficiary—unrelated to beneficiary health status or outcomes—provides evidence that health needs alone do not determine spending. Furthermore, recent analyses by GAO, MedPAC and others indicate the growth in volume and intensity of physician services varies dramatically across providers and specialties. Excessive volume and intensity not only increase program spending, but also may represent unnecessary services that can put beneficiaries at greater risk.

Strategies to evaluate growth in volume and intensity, and address unnecessary spending are currently being explored.  One such strategy would bundle services in the physician fee schedule to create a global fee for patient care management.  Bundled payments are used for most of Part A through various Prospective Payment Systems that use Diagnostic Related Groups and other similar mechanisms.  In Part B, Medicare bundles payments for End Stage Renal Disease and for certain surgeries.  Bundled payments could facilitate more careful patient management, while reducing administrative burden for physicians.

Another strategy being used to address growth in volume and intensity relies on providing feedback to individual physicians about how their practice patterns compare with their peers.  This approach is intended to generate dialogue so that Medicare physicians can learn from each other how to achieve the highest quality outcomes with efficient use of resources.  Such programs have been used effectively in the private sector.

In announcing this hearing, Chairman Stark said: “As Medicare’s steward, Congress needs to ensure that Medicare resources are being used efficiently and effectively to achieve high quality outcomes.  This hearing will bring out some concrete actions we can take to achieve this important goal.”

FOCUS OF THE HEARING:

The hearing will focus on potential methods to improve efficiency among physicians in Medicare.  In particular, witnesses will review the potential of bundling services in the physician fee schedule and the effect of providing feedback to physicians on how their clinical practice patterns and resource use compare to their peers.

DETAILS FOR SUBMISSION OF WRITTEN COMMENTS:

Please Note:  Any person(s) and/or organization(s) wishing to submit for the hearing record must follow the appropriate link on the hearing page of the Committee website and complete the informational forms.  From the Committee homepage, http://waysandmeans.house.gov, select “110th Congress” from the menu entitled, “Committee Hearings” (http://waysandmeans.house.gov/Hearings.asp?congress=18).  Select the hearing for which you would like to submit, and click on the link entitled, “Click here to provide a submission for the record.”  Once you have followed the online instructions, completing all informational forms and clicking “submit” on the final page, an email will be sent to the address which you supply confirming your interest in providing a submission for the record.  You MUST REPLY to the email and ATTACH your submission as a Word or WordPerfect document, in compliance with the formatting requirements listed below, by close of business Thursday, May 24, 2007.  Finally, please note that due to the change in House mail policy, the U.S. Capitol Police will refuse sealed-package deliveries to all House Office Buildings.  For questions, or if you encounter technical problems, please call (202) 225-1721.

FORMATTING REQUIREMENTS:

The Committee relies on electronic submissions for printing the official hearing record. As always, submissions will be included in the record according to the discretion of the Committee. The Committee will not alter the content of your submission, but we reserve the right to format it according to our guidelines. Any submission provided to the Committee by a witness, any supplementary materials submitted for the printed record, and any written comments in response to a request for written comments must conform to the guidelines listed below. Any submission or supplementary item not in compliance with these guidelines will not be printed, but will be maintained in the Committee files for review and use by the Committee.

1.   All submissions and supplementary materials must be provided in Word or WordPerfect format and MUST NOT exceed a total of 10 pages, including attachments.  Witnesses and submitters are advised that the Committee relies on electronic submissions for printing the official hearing record.

2.  Copies of whole documents submitted as exhibit material will not be accepted for printing.  Instead, exhibit material should be referenced and quoted or paraphrased.  All exhibit material not meeting these specifications will be maintained in the Committee files for review and use by the Committee.

3.  All submissions must include a list of all clients, persons, and/or organizations on whose behalf the witness appears.  A supplemental sheet must accompany each submission listing the name, company, address, and telephone and fax numbers of each witness.

Note:  All Committee advisories and news releases are available on the World Wide Web at http://waysandmeans.house.gov.

The Committee seeks to make its facilities accessible to persons with disabilities. If you are in need of special accommodations, please call 202-225-1721 or 202-226-3411 TTD/TTY in advance of the event (four business days notice is requested). Questions with regard to special accommodation needs in general (including availability of Committee materials in alternative formats) may be directed to the Committee as noted above.

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