Senators Max Baucus and Charles Grassley

Sen. Max Baucus (D-Montana), chair of the Senate Finance Committee, and Sen. Charles Grassley (R-Iowa), the committee’s ranking member, have released a trio of papers addressing options for the overhaul of the U.S. health care system.

“Transforming the Health Care Delivery System: Proposals to Improve Patient Care and Reduce Health Care Costs” (pdf), released on April 29, presents proposals for “revis[ing] payment systems and policies in the Medicare program to promote higher-quality, and more cost-effective care and to reduce fraud, waste and abuse throughout the health system.”

“Expanding Health Care Coverage: Proposals to Provide Affordable Coverage to All Americans” (pdf), released on May 14, outlines policies for providing a “high-performing health system [that] would guarantee all Americans affordable, quality coverage regardless of age, health status, or medical history.”

“Financing Comprehensive Health Care Reform: Proposed Health System Savings and Revenue Options” (pdf), released on May 20, outlines “policy options for financing comprehensive health care reform” that will ensure coverage for all Americans while reducing the rate of growth in healthcare spending.

PHI has submitted official comments to the Senate Finance Committee for two of these papers.

In comments on “Transforming the Health Care Delivery System” (pdf), PHI said it “encourages the committee to take special note of the nation’s direct-care workforce,” and described this workforce as “a vast and under-leveraged workforce ideally positioned to assist with chronic care management, health promotion, disease prevention and control of health care costs.”

PHI also suggested a new subsection to the delivery paper titled “Investing in the home- and community-based workforce for long-term services and support,” and recommended three workforce related infrastructure investments:

• Creating requirements for state workforce plans
• Improving training for frontline health care workers in HCBS settings
• Developing systems for workforce data collection and monitoring

In comments on “Expanding Health Care Coverage” (pdf), PHI said that it applauds the committee’s “efforts to make health care coverage more affordable and accessible to all Americans,” and pointed out that “as a workforce that is more likely to be uninsured, with higher rates of chronic health conditions and a very high incidence of workplace injuries, direct-care workers have much to gain from reform that both expands coverage and increases attention to screening, prevention and health promotion services.”

In a more critical vein, PHI called attention to “the serious workforce implications of the policy directions supported by the committee’s proposals,” namely, that “the twin goals of rebalancing and meeting expanding demand for long-term services and supports cannot be accomplished without a corresponding focus on building and sustaining an adequate workforce to supply these services.”