Source: Welch’s office. 10.22.2009# # # Congressman Peter Welch and a coalition of House members announced a breakthrough Thursday morning in reforming the Medicare payment system to reward quality health care. At a Capitol Hill press conference, Welch and the other members outlined the deal, which will change the way Medicare pays health care providers for services from its current system focused on volume of care to a quality and value-based system. By making reimbursement rates more equitable, states like Vermont with higher quality and lower cost care are expected to benefit from the agreement.“By rewarding quality – not quantity – of care, this agreement will save taxpayers billions of dollars and reduce costly, unnecessary procedures that fail to improve patient outcomes,” Welch said. “Reforming the current fee-for-service model is among the most critical elements of health care reform, and this breakthrough represents a significant step forward.”The Quality Care Coalition’s compromise added language to the health care reform bill changing Medicare to a quality-based payment system in two years. Specifically, the compromise would require the Institute of Medicine to conduct two studies on geographic variations and quality metrics. At the end of the two year study period, Medicare would switch to a quality-based reimbursement system unless Congress specifically cast a vote to disallow that change. Since the start of the health care reform debate, Welch has highlighted the work of Dr. Elliott Fisher and the Dartmouth Institute for Health Policy Research in identifying geographic disparities in Medicare reimbursement. Welch introduced legislation creating Accountable Care Organizations, which was included in the Energy and Commerce version of the health reform bill.
(REUTERS)-South Africa’s bowlers rallied magnificently after the loss of pace spearhead Dale Steyn before their batsmen pushed to an 102-run lead at the close on day two of the first Test against Australia yesterday.Steyn left the field with a shoulder injury before lunch and was later ruled out of the series with a stress fracture in a hammer blow for the touring side.But the remaining Proteas bowlers ripped out the hosts for 244 before tea before Dean Elgar (46 not out) and JP Duminy (36 not out) combined for an unbroken 59-run stand to steady the innings after two early wickets in the final session.South Africa were 104 for two at stumps having fought back strongly after Australia had dominated the first day.Vernon Philander took 4-56, teaming up brilliantly with debutant left-arm spinner Keshav Maharaj (3-56) as Australia lost 10 wickets for 84 runs after resuming in the morning at 105 without loss.“A few of us probably have to look at ourselves in the mirror and say why did we play those shots?,” opening batsman David Warner said of a collapse that included four ducks.Rising pace talent Kagiso Rabada took three wickets, with Steyn grabbing the first of the day to deny Warner a century.The Australian vice -captain and opener Shaun Marsh pushed Australia to 158 before Steyn had Warner caught in the slips for 97.Steyn exited in his following over but it did little to break the Proteas’ focus, with Rabada bowling Usman Khawaja for four and Maharaj grabbing a memorable first wicket, trapping Steven Smith lbw for a duck as the captain skipped down the wicket.Marsh was given out lbw in the final over before lunch and the rot continued after the break.Bowling a tight line and length, Philander and Maharaj ratcheted up the pressure with three straight maidens before Mitchell Marsh succumbed for an eight-ball duck.Adam Voges showed some resistance but Rabada caught a leading edge off his own bowling to dismiss him for 27.Mitchell Starc lasted only six balls before holing out for a duck off Maharaj, driving to South Africa captain Faf du Plessis at midwicket.Wicketkeeper Peter Nevill managed 23 before Josh Hazlewood (4) and Nathan Lyon, the fourth duck of the innings, fell quickly to wrap up the Australian innings.Shaun Marsh took a sharp catch at midwicket to dismiss Stephen Cook for 12 off paceman Peter Siddle and Josh Hazlewood bowled Hashim Amla for one, having dismissed him for a duck in the first innings.But Elgar and Duminy stood firm in the last hour to complete a fine day for South Africa and give the tourists hope of setting a big target on day three.DSOUTH AFRICA 1st innings 242 (Q. de Kock 84, T. Bavuma 51; M. Starc 4-71)Australia 1st innings (Overnight: 105-0)D. Warner c Amla b Steyn 97S. Marsh lbw b Philander 63U. Khawaja b Rabada 4S. Smith lbw b Maharaj 0A. Voges c&b Rabada 27M. Marsh lbw b Philander 0P. Nevill c Amla b Maharaj 23M. Starc c du Plessis b Maharaj 0P. Siddle not out 18J. Hazlewood c Duminy b Philander 4N. Lyon c Elgar b Philander 0Extras (lb-3 nb-5) 8Total (all out, 70.2 overs) 244Fall of wickets: 1-158 D. Warner,2-167 U. Khawaja,3-168 S. Smith,4-181 S. Marsh,5-181 M. Marsh,6-202 A. Voges,7-203 M. Starc,8-232 P. Nevill,9-243 J. Hazlewood,10-244 N. LyonBowling: D. Steyn 12.4 – 3 – 51 – 1, V. Philander 19.2 – 2 – 56 – 4(nb-3),K. Rabada 20 – 1 – 78 – 2(nb-2,K. Maharaj 18.2 – 5 – 56 – 3.SOUTH AFRICA 2nd inningsS. Cook c S. Marsh b Siddle 12D. Elgar not out 46H. Amla b Hazlewood 1J. Duminy not out 34Extras (lb-5 nb-1 w-5) 11Total (for 2 wickets, 40 overs) 104Fall of wickets: 1-35 S. Cook,2-45 H. AmlaTo bat: F. du Plessis, T. Bavuma, Q. de Kock, V. Philander, D. Steyn, K. Rabada, K. MaharajBowling: M. Starc 9 – 4 – 18 – 0, J. Hazlewood 10 – 2 – 31 – 1(nb-1),P. Siddle 8 – 4 – 12 – 1, M. Marsh 4 – 1 – 11 – 0(w-1),N. Lyon 9 – 2 – 27 – 0.