This post was filed from Doctors For America’s 2012 National Leadership Conference in Washington, D.C.

Zeke Emanuel — long caricatured by conservatives for supposedly supporting the rationing of care — assured a group of doctors attending Doctors For America’s annual conference on Monday morning that the health law would not control health care costs by rationing care. The law, he argued, will begin to change system incentives to encourage providers to deliver care more efficiently:

EMANUEL: We are spending $2.6 trillion…no one when we talk about cost control — no one, let me repeat, no one is talking about getting us from $2.6 to $2.7 trillion to $2 trillion. We’re talking about slowing the rate of growth. There is going to be plenty of resources in the system….Nobody is talking about health care costs going down. We’re talking about slowing the rate of growth. That’s what cost control is — control, not cost savings.

Indeed, the Congressional Budget Office (CBO) projected in 2011 that between 2013 and 2021, “growth in spending will be restrained by reductions in updates to payment rates that were included in the 2010 health care legislation.”

Virginia Gov. Bob McDonnell (R) signed a mandatory ultrasound bill into law last month, which will require all women who have an abortion in the state to have an ultrasound first, after backing off his earlier support for a more far-reaching version of the bill that would have required a more invasive ultrasound.

Despite his opposition to “invasive” TSA pat-downs, McDonnell still agreed with requiring women to undergo an additional medical prodecure because they “have a right to know” all available medical information before making a decision.

But his focus on a woman’s right to know ignores that the bill adds an unfunded, unnecessary burden for women seeking an abortion. In an interview with Bloomberg’s All Hunt, McDonnell stood by his “right to know” line without addressing if the law was a mandate:

MCDONNELL: The truth is that in almost all the cases already these ultrasounds are already required for medical reasons. [...] The important part, really, is to be able to show the woman the ultrasound along with all the medical information. [...]

HUNT: Suppose she and her doctor don’t think that’s necessary. You would still mandate it, though, right?

MCDONNELL: Well, again, it’s in a fairly small minority cases where it’s not being performed. But this is the policy that the legislature set. I thought it was the right policy.

Watch here:

The additional requirement throws up another barrier for women who want to have an abortion in Virginia. This invasive law, along with burdensome and expensive state regulations on abortion clinics, are Republican lawmakers’ attempts to limit women’s access to abortion procedures by making it difficult or forcing clinics to close.

Twenty of Virginia’s 23 abortion clinics affected by the new regulations that have gone into place reported that they already meet or will comply with the standards, such as larger hallways, bigger parking lots, and certain health and cooling controls. But complying with the standards was expensive, costing the clinics betweeen $150,000 to $3 million a piece. “These are difficult economic times,” Laura Meyers, president and CEO of Planned Parenthood Metropolitan Washington, told the Washington Examiner. “To put more onerous regulations on health care providers that are not necessary seems very counterproductive.”

This post was filed from Doctors For America’s 2012 National Leadership Conference in Washington D.C.

Zeke Emanuel — a senior fellow at the Center for American Progress — addressed the Doctors For America’s 2012 National Leader Conference Monday morning and urged physicians to remain engaged in the nation’s health care debate. Emanuel predicted that the Affordable Care Act will succeed in expanding coverage and slowing the growth of health care spending by 2020, but stressed that the biggest changes will occur in how health care providers deliver services to patients — an area which doctors must lead in shaping, he maintained.

Health care systems around the country are already moving away from the existing fee-for-service reimbursment system and coordinating care in a way that improves efficiency and care quality. These successes contain valuable lessons for the kind of delivery reforms the ACA hopes to foster and offer a glimpse into the system of the future. Emanuel explained what those changes will look like, relying on the real-world experiences of Group Health of Puget Sound in Washington state:

1) “It doesn’t look like lone doctors working alone. It looks like health care teams of doctors working with nurses, working with public health professionals.” Specialized groups of providers are better equiped to provide personalized care to patients with multiple chronic conditions, who consume two-thirds of the health care dollars.

2)”You don’t wait for the patient to come to you. You have active outreach to patients.” Providers track their pateints’ physiological indicators and call them to ensure that they’re complying with medication and other interventions.

3) “You have electronic health records so you can track patients over time … so that you can track physician, nurse and other quality performance in your group.”

4) “You also don’t treat patients individually. You have team huddles, you have team plans. You standardize care for patients.”

5) “You also create specialized clinics for chronic problems, have the best people you have doing that over and over.”

The results have been impressive. Sine adopting the changes, Group Health experienced a six percent drop in readmissions, a six percent decrease in length of stay, decreases in physician visits, but a dramatic increase in telephone calls and email communications. Most remarkably, the new system saved $1.50 for every $1.00 invested in the re-engering process over a 21-month period.

Providers also experienced a boost in morale “because the health staff finally felt like they were practicing the medicine they were trained to and not just doctor reimbursment,” Emanuel stressed.

That’s the future providers can look forward to. And now, they have to work to make sure it becomes a reality.

Our guest blogger is Lindsay Rosenthal, Special Assistant for Health Policy and Women’s Health and Rights at the Center for American Progress.

Last week, the Obama Administration announced that it would drastically scale up a program that uses competitive bidding to buy medical equipment for Medicare beneficiaries. The decision was made after the results of the first year of the competitive bidding program showed that competitive bidding saved $202 million in spending in 9 metropolitan areas, reducing Medicare expenditures on durable equipment by 42 percent, without sacrificing the quality of or access to care for Medicare beneficiaries. The Centers for Medicare and Medicaid Services (CMS) plans to expand the program to 100 metropolitan areas by 2013, and the entire country is expected to benefit from the program by 2016.

The savings in the first round of the competitive bidding program came from lowered prices for things like oxygen equipment, power wheelchairs, and mail-order test strips for people with diabetes. Instead of paying suppliers based on the current fee schedule that leaves Medicare paying prices well over market value, competitive bidding requires suppliers to compete for their contracts by offering better prices. The results of the first year of the program show that competitive bidding reduced the amount paid by Medicare for an oxygen concentrator from $2,079.72 per year to $1,393.92 per year and saved Medicare beneficiaries an average of $137 a year in cost sharing. Total savings on oxygen equipment alone during the first year of the program were over $59 million.

The savings that resulted from competitive bidding are no surprise— they’re matter of common sense and simple economics. As such, competitive bidding has enjoyed bipartisan support for quite some time. Yet this week’s announcement marks a hard-won victory for CMS, which has had a rocky time implementing competitive bidding against a lobby of suppliers invested in preserving the status quo.

Competitive bidding for durable medical equipment was first mandated as far back as 2003, with the passage of the Medicare Modernization Act. It was implemented in July 2008, but was only in progress for two weeks before all the contracts were terminated by a subsequent law supported by suppliers that delayed this reform. One of the primary concerns cited by suppliers was that small suppliers would be pushed out, unable to compete with larger companies. But the report released by CMS this week shows that approximately 51 percent of the suppliers who won bids were small suppliers.

Now that reform is under way, Medicare officials project that the competitive bidding program will save at least $42 billion over the next ten years, which is an important step in a larger effort towards reducing rising Medicare costs. Last year, the Center for American Progress proposed expanding competitive bidding in Medicare as part of a broader series of cost containment reforms that could save $100 billion or more in health care costs. We recommended not only requiring competitive bidding for all durable medical equipment, but also expanding the program to all medical devices and laboratory tests, among other products and services. Expanding the scope of the program to include medical devices, laboratory tests, and procedures such as outpatient radiological exams (like CT scans and MRIs) would increase the cost saving potential of competitive bidding, but would also require more technical expertise to implement. So CAP has proposed establishing a Medicare Competitive Bidding Committee, composed of individuals with private sector experience in acquisitions and experts in competitive bidding that would oversee the process to ensure preservation of quality and access.

Competitive bidding expansion and other payment and delivery system reforms are smart alternatives to the draconian Medicare cuts like those proposed by the Ryan Plan, which would shift the cost burden onto seniors and offer nothing in the way of meaningful reform for the healthcare system.