Shaheen Floor Statement on How Health Care Reform will Improve Care & Reduce Costs, October 21, 2009

I thank the Senator from Virginia for his comments. As he said, our health care system is on an unsustainable path. Now is the time to fix it.

Health care has not been working for families, for workers, for businesses, and for the Nation's economy. Today we are actually going to talk about some of the good news we know we can accomplish with health care reform. We are going to talk about what health care reform can do to help those families, workers, and the economy. It is our opportunity to control costs for Americans and to improve quality.

Let me be clear: We can control cost and improve quality at the same time. When we do this, we have to remember to keep patients at the center of the debate. The truth is, in so many cases the health care industry can do more for less. Usually I like to tell a story about what is going on with my constituents. It helps us keep people at the center of the debate.

Today I want to talk about some of the innovative health quality initiatives happening in New Hampshire. We all know hospital readmissions are a costly problem in the country. We have an exciting program going on in Manchester, the State's largest city, at the Elliot Senior Health Center. They recognized what was happening with readmissions. They recognized that hospital discharges can be confusing and sometimes overwhelming for seniors and that providing a little extra attention to help those seniors as they are transitioning out of the hospital can help keep them from being readmitted. They developed a program they call the TRACE Program. TRACE provides seniors with a health coach who helps patients with the tools and support to take a more active role in managing their medical care. The support those patients receive improves their understanding not only of their own health care, of the health care system in general, it helps keep them out of the hospital.

Senator Collins and I have introduced a bill that would help do this systemwide called the Medicare Transitional Care Act. It builds on successful programs such as the one at the Elliot Senior Health Center. Our legislation would improve the quality of care, reduce hospital readmissions, and lower costs. Research shows we can save $5,000 per Medicare beneficiary if we enact this kind of a program systemwide to deal with hospital readmissions. I am happy the key provisions of this idea are included in the Finance Committee bill. It will give us an idea of how this is going to work systemwide. It is one example of what we can do to improve the quality of care while we control cost.

There is another initiative we have been working on. I know all of us have been forced to wait in a crowded emergency room sometimes. Emergency room overcrowding is a problem that has become all too common. It is a symptom of what is going on in our health care system. Frequent users of health care services are a small but very costly portion of our population. They contribute to overcrowding in emergency rooms, and they raise costs for everyone. These individuals often have multiple chronic conditions. Sometimes they have mental illness. Sometimes they are faced with issues such as poverty and homelessness. They are among our most vulnerable but most frequent users of emergency rooms because they have nowhere else to go.

In one study, one individual used the emergency room 115 times in 1 year. This was in Camden, NJ. Another patient accumulated $3.5 million in hospital charges over 5 years. These are charges for which the American taxpayer paid the bill. Our health care system is not adequately dealing with frequent users of emergency rooms. The good news is, we can change this. Through increased outreach and coordination, we can reduce utilization. We can save costs. Research shows that after 2 years of participation in a program that provides this kind of coordinated care for people who use emergency rooms, usage of emergency rooms was cut by over half. This translates into significant savings for the taxpayer. It is the kind of reform we must continue to look at if we are going to change the health care system and make it work for taxpayers, for businesses, and for families.