McKinley Speech Highlights Forum on Medicare Reform

To those who experience life threatening conditions, "acute care" is a traumatic experience of its own.  A patient gets rushed to the hospital with a deadly wound, heart attack, or some other condition.  The doctors have to poke, prod, sometimes even cut, to stabilize the sufferer.  Most people perceive that a person needs a long stay in the hospital to rest and recuperate.  Or that they will certainly have to make exhausting trips to and from the hospital for care.  For all insurance providers, but particularly Medicare, hospital stays and visits can break the bank.

As the nation closes in on both a crisis of debt and of Medicare solvency, some in Congress have explored solutions.  Congressman Paul Ryan, now Republican vice presidential nominee, proposed a comprehensive plan several months ago.  David McKinley, Republican representative from West Virginia's first district has been working on ways to cut costs to providers while providing benefits to patients.

In Washington today, the Alliance for Home Health Quality and Innovation unveiled a plan called the Clinically Appropriate and Cost Effective Placement Study (CACEP) that relies less on hospitals and more on home based health resources.  McKinley said that it will save billions.  But more importantly, "patients can receive care in a setting where they feel most comfortable."

Currently, Medicare loses money through a fee-for-service payment system.  According to the AHHQI:

Models indicate that moving Medicare away from a siloed fee-for-service payment system to one that better aligns incentives by adding an explicit policy to reduce Medicare fee-for-service post-discharge spending by 7.5 percent would yield Medicare savings of $100 billion over 10 years.

In other words, the AHHQI calls for Medicare to adopt policies that are more flexible and can better accommodate home health care solutions.  The study also found that home health care settings tend to be less expensive than "formal first settings" such as hospitals. McKinley noted that "better post acute care leads to less hospital readmissions."

The Veterans' Administration's home health care system was illustrated as a viable alternative to Medicare's in that it is more effective, more flexible, and less expensive.

West Virginia, along with other rural and mountainous states, has particular problems with mobility and accessibility.  Despite having 52 hospitals and 50 rural clinics, many post acute care patients have difficulty getting to appointments and care. 

McKinley related how his family brought his mother home for care rather than extended hospitalization.  He described how she enjoyed better "quality of life" and "dignity of treatment."

The plan released by the AHHQI should provide a starting point for discussing improved care and addressing costs.  According to Executive Director Teresa Lee, "In releasing this report, we look forward to being part of further discussions on how post-acute care can be reformed to ensure that patients receive quality care in the least expensive setting."