Senator's health reform plan emphasizes medical homes

President-elect Barack Obama promised health-care reform during the campaign, and one lawmaker wants to get a head start on the process. Just days after the election, Senator Max Baucus (D-Montana) unveiled a broad-reaching and primary-care-focused reform plan.

Baucus, who chairs the Senate Finance Committee, which rules on Medicare issues, held nine hearings on reform in 2008 and a day-long health summit in June. His 98-page "Call to Action: Health Reform 2009" is not a legislative proposal, but a "vision for health-care reform," he states in the introduction.

The foundation of Baucus' plan is re-emphasizing primary care and creating a medical home for patients with chronic illnesses. He recognizes his plan can't be accomplished without improving payment to encourage more medical students to choose primary care.

Baucus' plan, however, is "budget-neutral," which means any Medicare payment boost for primary care will mean a cut for specialists. That move "has the potential to create significant controversy," according to the plan.

But rather than just adjusting Medicare Part B, where physicians are paid, Congress should instead dip into the budgets of Part A and Part D to even the playing field, says Ted Epperly, MD, president of the American Academy of Family Physicians.

"Otherwise, it's just going to be a food fight," he points out.