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Schwartz: Flexible Plans Ensure Local Control

As we seek to find a uniquely American solution to health care reform that ensures affordable, meaningful coverage for all Americans, contains rising health care costs and improves health outcomes, we must reward systemwide innovations that work to achieve these goals. There are important initiatives in the health care reform bill under consideration in Congress that will better enable Medicare payments to reward quality and better outcomes and improve care for millions of Americans.

I have championed many of these reforms, including ending co-payments for seniors’ preventive care, encouraging doctors and nurses to become “medical homes— to better coordinate care for patients with chronic diseases, improving access to primary care, reducing adverse medical events and expanding use of health information technology, to name just a few. These will undoubtedly improve health outcomes for seniors and save a significant sum of money for families and for taxpayers.

But we can do even more.

We should challenge health care providers and civic leaders around the country to find payment and delivery system innovations that work for their community, their health payment structure and their particular local attitude or style. We should encourage health care stakeholders to work together and take responsibility for the health of the people in a geographic area, across a full spectrum of health care services. They can determine how best to integrate a community’s health care delivery system to make it patient-centered and cost-effective as well as result in better care and improved health status for everyone in the community.

To enable this to happen, the federal government and private insurers need to offer unprecedented flexibility to collaborate, meld funding streams and encourage new ways to meet patient and community health needs. If health status improves and savings are achieved, providers should be able to keep some, if not most, of the savings, which can then be reinvested in health care services or serve as incentives for further improvements. We will all benefit from the improved health outcomes in our communities by the slower growth of health care costs for our public programs and costs of care for American families and businesses.

Building on the work already done in the delivery system reforms in the health care bill before us now, I have introduced the Healthcare Innovation Zone Program Act to spark these initiatives. It acknowledges that different communities may develop different systems. Each can identify the model that works best for them. Eliminating barriers to collaboration and rigid financial incentives will motivate communities to meet the challenges ahead.

It is also an approach that recognizes that we need reliable data to drive large-scale policy changes. We know that certain interventions work, like medical homes and transitional care after hospitals visits, but there are likely other large-scale modifications that can significantly improve our health and reduce costs. Health care innovation zones include academic medical centers — teaching hospitals and medical schools — so we will build in evaluation and research. In this way, we can all learn from the experiences of the health care innovation zones, disseminate their findings and expand this opportunity nationwide as appropriate.

The health care reform plan before Congress contains significant, meaningful reforms that will improve the quality of health care and curb the growth of health care spending in our country. This means we will not only expand coverage, but improve access to cost-effective, quality care as well. We must move forward. As we do, it will be important to evaluate our success in payment and delivery system reform, create incentives for improvements and allow for variations.

We must be open to new ideas and new innovations. Creating health care innovation zones would add to the potential transformation in financial incentives that not only reduces the rate of growth in health care costs but leads to better access to care and improved health status for all of us.

Rep. Allyson Schwartz (D-Pa.) is vice chairwoman of the Budget Committee, a member of the Ways and Means Committee and vice chairwoman of the New Democrat Coalition.

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