Public Health Service Act

PUBLIC HEALTH SERVICE ACT

Mr. GRASSLEY. Mr. President, I want to take a few minutes to explain my recent action related to S. 1418, the Wired for Health Care Quality Act. Today, with great reluctance, I asked Leader Frist to consult with us prior to any action related to consideration of this bill, which the Health, Education, Labor, and Pensions Committee reported by voice vote this morning.

The Wired for Health Care Quality Act would promote the use of electronic health records by adopting standards for the electronic exchange of information, offer incentives for health care providers to create networks for secure exchange of electronic health information, and ensure quality measurement and reporting of provider performance under the Public Health Service Act.

I fully support linking the adoption of health information technology to quality improvements in our health care system. They go hand in hand. Which is why Senator Baucus and I decided to introduce our Medicare Value Purchasing Act, S. 1356, jointly with Senators Enzi and Kennedy's Better Healthcare Through Information Technology Act, S. 1355. The thought behind a dual introduction was to enforce the message that Medicare can drive quality improvement through payment incentives, and that the adoption of information technology is also a necessary step not only to facilitate the reporting of quality measures but also to increase efficiency and quality in our health care delivery system.

Our bill creates quality payments under Medicare for all provider groups. A considerable amount of time was devoted towards ensuring that the development of quality measures and the implementation of value-based purchasing programs under Medicare were properly vetted with provider groups, beneficiary groups, and the administration. We did not want to reinvent the wheel; we wanted to build on the initiatives that already exist to develop and adopt quality measures. And because Medicare is the single largest purchaser of health care in the Nation, adopting quality payments in Medicare influences the level of quality in all of health care. We have seen time and time again how when Medicare leads, the other public and private purchasers follow.

Which is why I am troubled, that as currently drafted, S. 1418 would require the development of quality measures under the Public Health Service Act. It is hard to comprehend how the quality measurement system in this bill intersects with the quality measurement system developed in the Medicare Value Purchasing Act. The last thing we want to do is end up with two different quality measurement systems. This has the potential to derail both proposals, effectively terminating or at least postponing the common goal of improving the quality of patient care.

The Wired for Health Care Quality Act would also direct the Secretary of Health and Human Services, along with the Secretary of Defense, the Secretary of Veterans Affairs, and other heads of relevant Federal agencies to jointly develop a quality measurement system. The coordination among all these Federal agencies alone is a massive project that could indefinitely stall the development and implementation of appropriate quality measures or result in one that falls to the lowest common denominator. That could actually set back quality efforts.

I welcome the opportunity to work with the sponsors of S. 1418, Senators Enzi, Kennedy, Frist, and Clinton along with members of the Health, Education, Labor, and Pensions Committee on this matter. I had hoped to accomplish that before the bill was introduced on the floor. Unfortunately, that did not happen. I do not take actions such as these lightly. But I am deeply troubled that, as currently drafted, the Wired for Health Care Quality Act could end up unintentionally delaying our common goal of improving the quality of health care for all Americans.

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