Obama says he's ready to sign fix of Medicare doctor payments, without endorsing legislation

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WASHINGTON — President Barack Obama said Wednesday that he's ready to sign good bipartisan legislation to fix Medicare's doctor payment problem, without endorsing any specific legislation.

Without a fix, doctors face a 21 percent cut in Medicare fees, the consequence of a 1990s budget law that Congress has repeatedly waived.

The House is expected to vote Thursday on a bill with rare support from both top leaders in the House that would permanently fix the problem. Obama backed the idea of a fix at a White House event marking this week's five-year anniversary of his signing the Affordable Care Act, while stopping short of backing the House compromise.

"As we speak, Congress is working to fix the Medicare physician payment system. I have my pen ready to sign a good bipartisan bill," he said.

Asked later if that means Obama would sign the House bill, White House press secretary Josh Earnest said the administration doesn't have a position on it. But Earnest said the White House puts "a lot of stock" into Democratic Leader Nancy Pelosi's position in support of the legislation.

Republican House Speaker John Boehner also is behind the bill, in an unusual show of bipartisanship on health care amid the battles over President Barack Obama's overhaul. "If something bipartisan emerges from the House, that would be good news," Earnest said.

The House bills calls for a period of basically stable reimbursements, followed by gradually shifting a larger share of doctors' pay so that it's keyed to quality, rather than quantity, of service. The Medicare fix is packaged with an extension of children's health insurance, funding for community health centers and dozens of other provisions. The outlook in the Senate is unclear.

The legislation aims for the political center and is being criticized from the right and the left. Conservatives don't like that most of the cost will be added to the federal deficit. Liberals object to higher premiums for upper-income beneficiaries, when drug companies are not being asked to share the burden through Medicare rebates.

Obama also announced a cost-cutting effort that the White House calls a Health Care Payment Learning and Action Network. The White House says more than 2,800 health care providers, patients and consumer groups have agreed to take part.

The goal is to tie more payments for health care services to the quality — not quantity — of services rendered. Earlier this year the administration set a goal to tie 30 percent of Medicare payments to quality and value, but Obama wants to go further.

"A central notion in the Affordable Care Act was we had an inefficient system with a lot of waste that didn't also deliver the kind of quality that was needed that often put health care providers in a box where they wanted to do better for their patients, but financial incentives were skewed the other way," Obama said.

"We don't need to reinvent the wheel — you're already figuring out what works to reduce infections in hospitals or help patients with complicated needs," Obama told health care providers gathered in the Eisenhower Executive Office Building next to the West Wing. "What we have to do is to share these best practices, these good ideas, including new ways to pay for care so that we're rewarding quality."


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