[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 3216 Introduced in Senate (IS)]







110th CONGRESS
  2d Session
                                S. 3216

  To provide for the introduction of pay-for-performance compensation 
 mechanisms into contracts of the Department of Veterans Affairs with 
  community-based outpatient clinics for the provision of health care 
                   services, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             June 26, 2008

 Mr. McConnell introduced the following bill; which was read twice and 
             referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
  To provide for the introduction of pay-for-performance compensation 
 mechanisms into contracts of the Department of Veterans Affairs with 
  community-based outpatient clinics for the provision of health care 
                   services, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Veterans Health Care Improvement Act 
of 2008''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Veterans of the Armed Forces have made tremendous 
        sacrifices in the defense of freedom and liberty.
            (2) Congress recognizes these great sacrifices and 
        reaffirms America's strong commitment to its veterans.
            (3) As part of the on-going congressional effort to 
        recognize the sacrifices made by America's veterans, Congress 
        has dramatically increased funding for the Department of 
        Veterans Affairs for veterans health care in the years since 
        September 11, 2001.
            (4) Part of the funding for the Department of Veterans 
        Affairs for veterans health care is allocated toward community-
        based outpatient clinics (CBOCs).
            (5) Many CBOCs are administered by private contractors.
            (6) CBOCs administered by private contractors operate on a 
        capitated basis.
            (7) Some current contracts for CBOCs may create an 
        incentive for contractors to sign up as many veterans as 
        possible, without ensuring timely access to high quality health 
        care for such veterans.
            (8) The top priorities for CBOCs should be to provide 
        quality health care and patient satisfaction for America's 
        veterans.
            (9) The Department of Veterans Affairs currently tracks the 
        quality of patient care through its Computerized Patient Record 
        System. However, fees paid to contractors are not currently 
        adjusted automatically to reflect the quality of care provided 
        to patients.
            (10) A pay-for-performance payment model offers a promising 
        approach to health care delivery by aligning the payment of 
        fees to contractors with the achievement of better health 
        outcomes for patients.
            (11) The Department of Veterans Affairs should begin to 
        emphasize pay-for-performance in its contracts with CBOCs.

SEC. 3. PAY-FOR-PERFORMANCE UNDER DEPARTMENT OF VETERANS AFFAIRS 
              CONTRACTS WITH COMMUNITY-BASED OUTPATIENT HEALTH CARE 
              CLINICS.

    (a) Plan Required.--Not later than one year after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall submit 
to Congress a plan to introduce pay-for-performance measures into 
contracts which compensate contractors of the Department of Veterans 
Affairs for the provision of health care services through community-
based outpatient clinics (CBOCs).
    (b) Elements.--The plan required by subsection (a) shall include 
the following:
            (1) Measures to ensure that contracts of the Department for 
        the provision of health care services through CBOCs begin to 
        utilize pay-for-performance compensation mechanisms for 
        compensating contractors for the provision of such services 
        through such clinics, including mechanisms as follows:
                    (A) To provide incentives for clinics that provide 
                high-quality health care.
                    (B) To provide incentives to better assure patient 
                satisfaction.
                    (C) To impose penalties (including termination of 
                contract) for clinics that provide substandard care.
            (2) Mechanisms to collect and evaluate data on the outcomes 
        of the services generally provided by CBOCs in order to provide 
        for an assessment of the quality of health care provided by 
        such clinics.
            (3) Mechanisms to eliminate abuses in the provision of 
        health care services by CBOCs under contracts that continue to 
        utilize capitated-basis compensation mechanisms for 
        compensating contractors.
    (c) Implementation.--The Secretary shall commence the 
implementation of the plan required by subsection (a) unless Congress 
enacts an Act, not later than 60 days after the date of the submittal 
of the plan, prohibiting or modifying implementation of the plan. In 
implementing the plan, the Secretary may initially carry out one or 
more pilot programs to assess the feasability and advisability of 
mechanisms under the plan.
    (d) Reports.--Not later than 180 days after the date of the 
enactment of this Act and every 180 days thereafter, the Secretary 
shall submit to Congress a report setting forth the recommendations of 
the Secretary as to the feasability and advisability of utilizing pay-
for-performance compensation mechanisms in the provision of health care 
services by the Department by means in addition to CBOCs.
                                 <all>