Mercy Advocacy Agenda 2003

Proactive Issues

1)   Medicaid Reform

As part of his 2004 budget proposal the President has proposed sweeping changes to Medicaid and SCHIP; these changes would have huge implications for over 40 million people who get health care and long term care through the program, and for the states and local communities.  As the economy continues to falter, the states are reporting cumulative budget deficits of over $50 billion this year, with estimates of over $80 billion next year; these are already producing reductions in coverage and benefits, with more to come. The federal government must keep its commitment to those served Medicaid, including: the poor, disabled, elderly and children. Mercy will work to ensure that our nation's health care safety net is protected and safeguarded.

2)   Tort Reform

Mercy supports a federal solution to curb the cost of health care liability. Federal tort reform legislation will reduce obstacles to quality care, contain costs and promote efficiency. While some states have passed effective liability reform, a federal response will result in consistency in medical liability cases. Federal legislation, however, should preempt only those state laws that are less effective than the proposed federal law.                              

3)   Medicare Reform

Mercy supports efforts to revise and upgrade the Medicare Program in a manner that promotes correlation between benefits covered and payment structure. However, Medicare reform must protect the poor and disabled. Mercy will support legislation that better correlates specific program benefits with payment policies while preserving Medicare coverage for the elderly and disabled.  Additionally, Mercy will continue to support legislation to establish a “floor” on the Medicare area wage index to help hospitals attract and retain qualified workers. Mercy will oppose any attempts to include Medicare Payment Reductions in the FY 2004 Budget.

4)  Access to Basic Health Services

Federal health coverage expansion proposals continue to be targeted and incremental. Coverage and access legislation can be expected in expansions in eligibility for government healthcare programs, new tax credits for individuals and businesses, and efforts to increase access to care in low-income communities. Mercy supports legislation that would take important steps toward expanding health coverage and increasing access to millions of uninsured families.

Monitoring Issues

·   Clinical Quality

Mercy quality promotes safe, effective, efficient, equitable, timely and compassionate clinical and personal service for individuals and their families.  Exceptional service has, as its foundation, Mercy’s definition of quality: Mercy Quality is customer-centered, knowledge-based, and collaborative-minded clinical and personal service that increases the likelihood of desired health outcomes.

As such, Mercy will support legislative initiatives that revamp payment strategies to more appropriately promote "best practices” in the provision of health care.  Specific legislative focus will include:

Disease management

The Center for Medicare and Medicaid Service’s pilot demonstration project holds promise for offering disease management programs through health plan coverage.  However, from the provider perspective, Mercy has already demonstrated improved clinical outcomes by partnering directly with employers to provide cost-effective interventions and strategies through continuum-based disease management programs.  As a provider, enhanced databases exist that provide a wealth of clinical information not available through the health plans. Mercy will work to educate legislators to promote a payment structure that appropriately rewards disease management programs.

New Technologies

The introduction of new medical devices, drugs, biologicals, and clinical practice patterns and procedures, poses a major dilemma for the Medicare program   While there are many approaches for funding new technologies, developing appropriate mechanisms to pay for them will be difficult.  Mercy will work to ensure that policy makers find a solution that appropriately balances access to services with the financial sustainability for hospitals providing new technology services. 

·   Medical Event reporting

To improve patient safety, the protection of sensitive quality information is imperative.  Mercy supports a national and uniform reporting system for which the primary and demonstrable purpose of the reporting system is the improvement of patient safety and not the punishment of facilities or providers. To be effective, Legal liability protection must exist for internal reviews and external reports of providers in a system that reports information to an independent, third party.

·   Conscience Clause

Increasingly Catholic health care providers have come under attack for not offering so-called "reproductive health services." In several states and for certain federal programs, Catholic and other faith-based providers have been able to secure a "conscience clause" protecting against mandatory provision of objectionable services. However, these conscience clauses are often inadequate.  Catholic health care facilities and other faith-based providers should be afforded adequate legal protections to ensure they are not forced to provide services that are contrary to their fundamental moral values. Mercy will work in coalition with other health care providers to ensure conscience clause protections.

·   Mental Health Parity

The 1999 Surgeon General’s Report on Mental Health called for establishing mental health parity and thereby ending the practice of limiting mental health care coverage and denying people access to needed mental health treatments.   The report confirms that nearly two-thirds of all Americans with diagnosable mental health disorders do not receive treatment. Mercy supports legislation which provides full parity for all categories of mental health conditions (other than substance abuse disorders) listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). 

·  Trauma care-ER/ Bio-terrorism

The threat of chemical, biological and radiological agents has become a focus of counter terrorism efforts. The role of hospital clinicians in quickly recognizing and treating symptoms and illnesses is critical to minimizing the impact of bioterrorism.  Mercy will support initiatives and legislation to assist hospitals in meeting the many challenges posed by the threat of bioterrorism.

·   Work Force

Mercy will continue to support legislative efforts designed to; increase funding for health professionals education programs, new programs for retraining, tax incentives for loan forgiveness and choosing jobs in shortage positions, tax incentives and grants for improving worker environment, and immigration flexibility.