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Wyden Pushes Bipartisan Medicare Overhaul Focused on Chronic Disease, Transparency

By Emily Ethridge, CQ Roll Call

January 7, 2014 -- Ron Wyden, heir apparent to the Senate Finance Committee chairmanship, plans to push for bipartisan bills that he says will transform Medicare by focusing on chronic disease and increasing price transparency.

"Dealing with chronic disease, protecting the Medicare guarantee, and holding down costs—that's the ball game for Medicare," said the Oregon Democrat about the legislation. "That's where the money is!"

For now, Wyden won't discuss his plans or goals as prospective chairman, with current Chairman Max Baucus, D-Mont., likely to become ambassador to China soon following his nomination by President Barack Obama. Baucus' nomination was recently sent to the Senate.

"My view is there's one chairman at a time," Wyden said. "I'm on the Finance Committee and I'm assisting Chairman Baucus in any way that I can."

Finance as a panel is hugely influential in health policy in that it holds jurisdiction over Medicare, Medicaid and the Children's Health Insurance Program, and was one of the two Senate committees that produced the health care law (PL 111-148, PL 111-152). Wyden has long had a strong and enthusiastic interest in Medicare policy as well as the complexities of health care.

Despite his reluctance to talk about the chairmanship, Wyden already has several priorities for addressing problems in Medicare, including a bill he plans to introduce soon that would overhaul the program's approach to chronic conditions.

Treating beneficiaries with chronic conditions is one of the program's biggest cost drivers, and Wyden said improving their care would be "extraordinarily important" and "the heart of Medicare reform."

Wyden has been working with Johnny Isakson, R-Ga., on the bill for months, and said they will introduce it soon along with Rep. Peter Welch, D-Vt., and Rep. Erik Paulsen, R-Minn.

Coordination of care for beneficiaries would be emphasized for enrollees with chronic conditions, Wyden said. The bill would ensure that Medicare paid for care coordinators who track scheduling and doctors' visits, and make sure information is shared between medical offices.

Another priority for Wyden is ensuring that his provision on pricing transparency remains in a bill (S 1871) to replace Medicare's troubled physician payment system. The committee approved the bill in December with transparency language from Wyden and Iowa Republican Charles E. Grassley.

"I think this is hugely important, because the day that you get that information out there, the debate about health care is going to change forever," he said.

The language would establish a searchable database of Medicare payments that the public could access for free online.

Wyden said the provision "will be transformative in terms of making sure people have access to information, which everybody says is important, but until you get to the treasure trove of where the data is, which is Medicare, it hasn't gotten done."

Supporters hope to move the replacement legislation to the Senate floor in the first three months of 2014—a time period in which Wyden could ascend to the chairmanship. A three-month payment patch for physicians contained in a budget agreement (H J Res 59) will expire March 31.

Wyden said the committee bill makes several positive changes, including giving a hard date for moving away from Medicare's fee-for-service system and installing payment systems that reward the value of care.

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