[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 1302 Introduced in Senate (IS)]
111th CONGRESS
1st Session
S. 1302
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 18, 2009
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 2009''.
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.
(4) Mechanisms to ensure that veterans are not denied care
or face undue delays in receiving care.
(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.
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