The three Democratic members of Iowa’s delegation to the U.S. House of Representatives announced “a majory breakthrough” on the possible reform of the federal formulas that govern Medicare and Medicaid distributions.

According to a joint press release by U.S. Reps. Bruce Braley (Waterloo), Leonard Boswell (Des Moines) and Dave Loebsack (Mt. Vernon), the three have helped negotiate a compromise to health care reform that will effectively mandate a government move to a quality-centric payment system following a two-year study period.

The full press release is below:

Washington, DC – Reps. Leonard Boswell, Dave Loebsack, and Bruce Braley today announced a major breakthrough on the issue of Medicare payment reform as the healthcare reform debate continues to intensify in Congress.  Boswell, Loebsack, and Braley have been outspoken advocates for changing the way Medicare pays healthcare providers for services, from its current fee-for-service system into a quality and value-based system.

Boswell, Loebsack, and Braley helped negotiate a compromise adding language to the healthcare reform bill changing Medicare to a quality-based payment system in two years.  Specifically, the compromise would (1) require Medicare to conduct a two-year study on a value-based system, and (2) at the end of the two year study period, Medicare would switch to a quality-based system unless Congress specifically cast a vote to disallow that change.

“This compromise represents a major breakthrough in healthcare reform that will save taxpayers billions of dollars and reduce costly, unneeded procedures that don’t improve patient outcomes,” Congressman Braley said. “Our healthcare system should reward the best care.  A quality-based approach for Medicare will reduce costs to taxpayers and increase the quality of care for everyone, all while rewarding doctors in states like Iowa who provide the most efficient and effective healthcare.

“This issue has been a top concern of mine since I first entered Congress,” said Congressman Boswell. “This is a significant step forward for our state and the prospects of bringing real reform to our health care system.  I am pleased to have worked with my colleagues from Iowa on this massive fix and I am eager to see the final version of the bill.”

“Fixing the broken Medicare system so that our patients receive the highest quality care is critical to reforming the way health care works in this country,” said Congressman Loebsack. “By rewarding quality, we help ensure that patients are diagnosed correctly, are not forced to undergo unnecessary procedures, and have access to quality health care providers. It’s about time we rewarded care based on quality, not quantity.”

Medicare currently operates under a fee-for-service system, basing payments to doctors and hospitals on the amount of procedures completed and the number of patients seen.  This system creates a financial incentive to order more and more procedures.  Ironically, according to many studies, this increased number of procedures does not result in better outcomes for patients.

Boswell, Loebsack, and Braley have strongly advocated a switch to a Medicare payment system based on value and quality, which determines payments based on procedures’ effect on patient health.  In June, Rep. Braley introduced the Medicare Payment Improvement Act with Rep. Ron Kind (D-WI).  Reps. Boswell and Loebsack are co-sponsors of the legislation.  The bill would have required Medicare to switch to a quality-based payment system, outlining specific details on how to measure quality and value.