TAILIEUCHUNG - Reforming the Health Care Delivery System June 25, 2009

With regard to submission, evaluation and selection procedures, both single-stage as well as two-stage submission and evaluation procedures will be used in separate calls. The relevant call is indicated for each topic in section II and the details for the procedures in separate call fiches in section III. It is particularly important that applicants address the potential ethical issues of their proposals, both in the proposed methodology and the possible implications of the results. The specific requirements for addressing ethical issues 24 are described in the Guide for Applicants (Annex 4, section 4). The differences of gender/sex in research. | B n I A Medicare Ivl r CJi jZXr A Payment Advisory 1 1 I Commission TESTIMONY Reforming the Health Care Delivery System June 25 2009 Statement of Glenn M. Hackbarth . Chairman Medicare Payment Advisory Commission Before the Committee on Energy and Commerce Subcommittee on Health . House of Representatives Glenn M. Hackbarth . Chairman Francis J. Crosson . Vice Chair Mark E. Miller . Executive Director 601 New Jersey Avenue NW Suite 9000 Washington DC 20001 202-220-3700 Fax 202-220-3759 Chairman Waxman Chairman Pallone Ranking Member Barton Ranking Member Deal distinguished Committee members. I am Glenn Hackbarth chairman of the Medicare Payment Advisory Commission MedPAC . I appreciate the opportunity to be here with you this morning. The health care delivery system we see today is not a true system Care coordination is rare specialist care is favored over primary care quality of care is often poor and costs are high and increasing at an unsustainable rate. Part of the problem is that Medicare s fee-for-service FFS payment systems reward more care and more complex care without regard to the value of that care. In addition Medicare s payment systems create separate payment silos . inpatient hospitals physicians post-acute care providers and do not encourage coordination among providers within a silo or across the silos. We must address those limitations creating new payment methods that will reward efficient use of our limited resources and encourage the effective integration of care. Medicare has not been the sole cause of the problem nor should it be the only participant in the solution. Private payer rates and incentives perpetuate system inefficiencies and the current disconnect among different payers creates mixed signals to providers. This contributes to the perception that one payer is cross-subsidizing other payers and further exacerbates the problem. Private and other public payers will need to change payment systems to .

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