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house Bill H.R. 2570

Studying the Affects Pricing Medical Procedures Based on Patient Need, Not Cost

Argument in favor

This bill opens the door for exploring ways to ensure that everyone can get the treatment that they need — no matter the price. No one should be denied care because they can’t afford it, nor should they be saddled which medical bills.

Scott's Opinion
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08/10/2015
Health and life should not be about profits.
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Claude's Opinion
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10/04/2015
Medicare for all. Socialized medicine ain't a bad thing.
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Gwen's Opinion
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01/25/2017
Only be studying and documenting what we "know" to be true can produce the kind of statistical evidence to justify legislation to lower copays for all patients.
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Argument opposed

There’s a reason some treatment costs a lot of money: it costs the hospitals a lot of money. They’re not profit-crazed money machines — they’re often just trying to stay afloat.

AndrewGVN's Opinion
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10/28/2015
Treatments cost a certain amount of money for a specific reason. Hospitals need to stay afloat, and I see this study leading to ultimate failure.
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Carey's Opinion
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06/15/2016
Any time the government gets involved, costs go up.
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Mark's Opinion
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03/03/2016
If you can't afford it then you are not meant to get it.
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What is House Bill H.R. 2570?

This bill seeks to increase access to medical facilities by studying how lower co-payments for people on Medicare impacts how often they go to the doctor, and general "clinical outcomes." 

Two years after the bill is passed, a three year program would be initiated to study “value-based insurance design.” This model essentially sets the price for treatments and prescriptions based on how important they are to the patient — not how much they cost the hospital. The program would be rolled out at two Medicare facilities chosen by the Secretary of Health and Human Services (HHS).

Patrons of the facility would, of course, have to be notified that the study was underway. The facility would also have the power to choose which treatments and prescriptions would have their prices reduced for the study. The study gives these facilities permission to do away with copayments, but they can’t raise them.

One year after completing the study, the HHS would have to submit a report to Congress. The program would also be reviewed by an independent agency.

Impact

Medicare recipients, especially those at the chosen facilities, facilities in the study and their staff, health care policymakers, and the Department of Health and Human Services.

Cost of House Bill H.R. 2570

A CBO cost estimate is unavailable.

More Information

Of Note: The Affordable Care Act now requires some medical treatments be given without copayment. It also allowed the HHS to begin setting up guidelines for value-based insurance design. 

They’re still working on it, but others have begun to make use of them. Oregon’s public employees use a value-based system, and at least one study has found it effective. But raising the price for some treatments — which this bill doesn’t allow — might be a necessary part of the equation. The insurance board had to raise prices for some procedures after finding that they were overused.


In Depth: Sponsoring Rep. Diane Black released a version of this bill in 2014. That bill, like this one, has bipartisan support.


Media:

Summary by James Helmsworth
(Photo Credit: Flickr user USDAgov

AKA

Strengthening Medicare Advantage through Innovation and Transparency for Seniors of 2015

Official Title

To amend title XVIII of the Social Security Act with respect to the treatment of patient encounters in ambulatory surgical centers in determining meaningful EHR use, establish a demonstration program requiring the utilization of Value-Based Insurance Design to demonstrate that reducing the copayments or coinsurance charged to Medicare beneficiaries for selected high-value prescription medications and clinical services can increase their utilization and ultimately improve clinical outcomes and lower health care expenditures, and for other purposes.

bill Progress


  • Not enacted
    The President has not signed this bill
  • The senate has not voted
      senate Committees
      Committee on Finance
  • The house Passed June 17th, 2015
    Passed by Voice Vote
      house Committees
      Committee on Energy and Commerce
      Health
      Committee on Ways and Means
      Health
    IntroducedMay 22nd, 2015

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