[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2535 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 2535

To establish a Blueprint for Health in order to create a comprehensive 
system of care incorporating medical homes to improve the delivery and 
    affordability of health care through disease prevention, health 
    promotion, and education about and better management of chronic 
                              conditions.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 20, 2009

  Mr. Welch introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
To establish a Blueprint for Health in order to create a comprehensive 
system of care incorporating medical homes to improve the delivery and 
    affordability of health care through disease prevention, health 
    promotion, and education about and better management of chronic 
                              conditions.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Blueprint for 
Health Act of 2009''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Purpose.
Sec. 3. Establishment of a Blueprint for Health for disease prevention, 
                            health promotion, and education about and 
                            better management of chronic conditions.
Sec. 4. Strategic plan.
Sec. 5. Chronic care management programs.
Sec. 6. Incentives for prevention of chronic disease.
Sec. 7. Health information technology.
Sec. 8. Recommendations to Congress; annual report.

SEC. 2. PURPOSE.

    It is the purpose of this Act to establish a Blueprint for Health 
which is designed--
            (1) to create a national integrated medical home model of 
        care that enhances primary care, encourages multidisciplinary 
        coordination, and promotes disease prevention, health 
        promotion, and education about and better management of chronic 
        conditions;
            (2) to increase Americans' access to affordable, 
        appropriate, high quality care through the use of the 
        integrated medical home model; and
            (3) to reduce costs to the United States health care system 
        through the application of such model.

SEC. 3. ESTABLISHMENT OF A BLUEPRINT FOR HEALTH FOR DISEASE PREVENTION, 
              HEALTH PROMOTION, AND EDUCATION ABOUT AND BETTER 
              MANAGEMENT OF CHRONIC CONDITIONS.

    (a) In General.--The Secretary of Health and Human Services (in 
this Act referred to as the ``Secretary'') shall create consistent with 
this Act a program (in this Act referred to as the ``Blueprint for 
Health'') that provides a national infrastructure for disease 
prevention, health promotion, and education about and better management 
of chronic conditions through the use of a nationwide integrated 
medical home model of care (in this Act referred to as the ``integrated 
medical home model of care'') in a manner that is designed to initiate, 
coordinate, and evaluate measures for promoting health and preventing 
disease in the United States.
    (b) Elements of Blueprint.--The Blueprint for Health shall include 
the following elements:
            (1) Strategic plan.--A strategic plan described in section 
        4 for designing the integrated medical home model of care.
            (2) Chronic care management programs.--Chronic care 
        management programs described in section 5.
            (3) Prevention incentives.--Incentives for the prevention 
        of chronic disease described in section 6.
            (4) Assessment of hit initiatives.--A plan described in 
        section 7 for the assessment of current health information 
        technology initiatives.
    (c) Executive Committee.--
            (1) In general.--The Secretary shall convene an executive 
        committee to advise the Secretary on the creation and 
        implementation of the Blueprint for Health.
            (2) Composition.--The executive committee shall include 
        representation from national and State medical, hospital, and 
        pharmaceutical associations, consumer and patient advocacy 
        groups, labor groups, employer and other purchasing groups, and 
        the health insurance industry.

SEC. 4. STRATEGIC PLAN.

    The Blueprint for Health shall include a strategic plan for 
designing the integrated medical home model of care that includes the 
following:
            (1) Recommended elements of an integrated coordinated 
        chronic care management model that incorporates the following:
                    (A) Medical practices acting as medical homes in 
                being primary caregivers in close coordination with 
                other elements. The elements for such homes may be 
                based on guidelines developed for such homes by the 
                National Committee for Quality Assurance.
                    (B) Early disease detection and risk 
                stratification.
                    (C) Community care teams that provide care support 
                for medical homes and assist in coordinating care among 
                medical homes, hospitals, prevention programs, 
                multidisciplinary specialists, and others.
            (2) A plan for the formation of such community care teams 
        that may include panel managers, public health prevention 
        specialists, nurse coordinators, social workers, dieticians, 
        community health workers, care coordinators, behavioral health 
        specialists, and other patient support personnel.
            (3) Incentives for patient self management, community-based 
        initiatives, and system and information technology reforms, 
        intended for use by all providers and health plans, including 
        Medicare, Medicaid, the Federal employees health benefits 
        program, and other Federal programs.
            (4) A description of recommended prevention programs and a 
        strategy for integrating them into the integrated medical home 
        model of care.
            (5) A plan to ensure that chronically ill patients have a 
        low level of cost sharing under the integrated medical home 
        model of care.
            (6) Alignment of health care information technology 
        initiatives with information technology needs.
            (7) Development and use of outcome and reporting measures 
        designed to track the progress of patients meeting clinically 
        recommended treatment goals.
            (8) A strategy for ensuring the broad support of the 
        integrated medical home model of care by health insurers, 
        hospitals, and health care professionals, including specialists 
        and other physicians.
            (9) Recommendations for better integrating specialty care 
        services into primary care practices to ensure care 
        coordination and the use of best practices.
            (10) Recommendations for the consultation of providers 
        experienced with the development and implementation of an 
        integrated medical home model of care as this Act's care 
        coordination model is developed.
            (11) A strategy for standardizing outcome and financial 
        measures to ensure consistency among all health plans, 
        including Medicare, Medicaid, the Federal employees health 
        benefits program, and other Federal programs.

SEC. 5. CHRONIC CARE MANAGEMENT PROGRAMS.

    The Secretary shall include in the Blueprint for Health chronic 
care management programs which provide for at least the following:
            (1) Methods for identifying and enrolling chronically ill 
        patients and for encouraging primary care physicians, 
        specialists, hospitals, and others to participate in such 
        programs.
            (2) Development of health risk appraisal or assessment for 
        individuals enrolled under Medicare, Medicaid, or the Federal 
        employees health benefits program.
            (3) A process for coordinating care among health 
        professionals including multidisciplinary care teams and 
        specialty care providers.
            (4) Methods for increasing communication among health care 
        professionals and patients, including patient education, self-
        management, and follow up plans.
            (5) Process and outcome measures to provide performance 
        feedback for health care professionals and information on the 
        quality of care.
            (6) Payment methodologies to create financial incentives 
        for patient participation and to allow primary care physicians 
        to meet specific standards of a medical home program. Such 
        financial incentives shall include--
                    (A) enhanced payment to medical practices, such as 
                a per member per month fee, based on standards for a 
                medical home, such as the National Committee for 
                Quality Assurance standards for a patient centered 
                medical home;
                    (B) payment for care support services, such as 
                community care teams or other applicable approaches, 
                across all insurers, including multi-payer private 
                plans and Medicare, Medicaid, and other public plans; 
                and
                    (C) the support of a community based savings 
                sharing and reinvestment model, such as an accountable 
                care organization, which incorporates a balanced set of 
                financial and quality incentives, such as the Institute 
                for Healthcare Improvement's Triple Aims.

SEC. 6. INCENTIVES FOR PREVENTION OF CHRONIC DISEASE.

    (a) In General.--The Secretary shall include in the Blueprint for 
Health a plan to provide incentives to prevent chronic diseases, 
including investments in healthy and sustainable local and regional 
food systems as well as the broader use of lifestyle changes, such as 
through diet, exercise, and smoking cessation in the schools, 
communities, and workplace.
    (b) Compilation of Effective Practices.--Based on recommendations 
set forth by the United States Preventive Services Task Force, the 
Secretary shall compile a list of effective practices that would serve 
as a basis for establishing programs to prevent chronic disease and 
that could be included in the Blueprint for Health.
    (c) Recommendations.--The plan under subsection (a) may include the 
following:
            (1) Grant opportunities and Federal tax credits for 
        localities to conduct community assessment, intervention, and 
        activation plans in which public health data are collected and 
        analyzed to identify areas in greatest need of prevention and 
        wellness programs.
            (2) Federal tax credits and incentive grants to local 
        education agencies, businesses, local departments of public 
        health, communities, hospitals, health care providers, and 
        other entities so that they may adopt effective models of 
        wellness shown to lower costs and improve health.
            (3) Incentives for individuals to take proactive 
        preventative measures, including weight management and smoking 
        cessation.
            (4) Federal tax credits and incentive grants to local 
        education agencies, businesses, local departments of public 
        health, communities, hospitals, health care providers and other 
        entities to promote the development of healthy and sustainable 
        local and regional food systems.

SEC. 7. HEALTH INFORMATION TECHNOLOGY.

    (a) In General.--The Blueprint for Health shall promote the 
effective, efficient, national use of health care information 
technology initiatives.
    (b) Assessment.--As part of the Blueprint for Health, the Secretary 
shall commission an assessment to be presented to Congress not later 
than two years after the date of the enactment of this Act that 
examines the implementation of the health information technology 
provisions enacted as part of the American Recovery and Reinvestment 
Act of 2009 (Public Law 111-5). This assessment shall evaluate the 
implementation of such provisions as they apply to chronic care 
management, and determine if further action is needed to ensure that 
the funding provided in such Act under such provisions is used 
effectively and efficiently to help ensure the effective management of 
chronic disease.

SEC. 8. RECOMMENDATIONS TO CONGRESS; ANNUAL REPORT.

    (a) In General.--Not later than 1 year after the date of the 
enactment of this Act, the Secretary shall present to Congress 
recommendations for legislation to implement the Blueprint for Health, 
including the establishment of programs designed to enhance primary 
care, promote multidisciplinary care coordination, prevent disease, 
improve quality, contain costs, more effectively manage chronic 
illness, and promote good health and prevention initiatives.
    (b) Annual Report.--The Secretary shall submit an annual report to 
Congress on the status of the implementation of the Blueprint for 
Health.
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