[Congressional Record (Bound Edition), Volume 145 (1999), Part 6] [Extensions of Remarks] [Page 8677] [From the U.S. Government Publishing Office, www.gpo.gov]IMPROVING MEDICARE QUALITY THROUGH PURCHASING: THE OHIO EXPERIENCE ______ HON. FORTNEY PETE STARK of california in the house of representatives Wednesday, May 5, 1999 Mr. STARK. Mr. Speaker, three weeks ago, I introduced H.R. 1392, the ``Centers of Excellence'' bill. H.R. 1392 would allow Medicare to provide incentives for beneficiaries to use certain high-volume, high- quality facilities. This initiative would both save lives, and save money for Medicare. It is a widely acknowledged fact that facilities that perform large numbers of complex procedures have lower mortality rates and fewer adverse outcomes. These facilities, known as ``Centers of Excellence,'' have become an important private sector tool for quality improvement and cost containment. An April 22 article in the Wall Street Journal highlighted an Ohio HMO with a Centers of Excellence program for heart procedures. After automatically removing facilities that performed fewer than 250 heart procedures per year from their list of preferred providers, the HMO conducted an extensive quality survey to determine the rating of the remaining facilities. This resulted in several more facilities being removed from the list, including some very reputable hospitals in the area. The Ohio experience showed that facilities with the best reputations for excellence did not necessarily have the best outcomes. Being removed from the Ohio HMO's preferred provider list was a strong competitive incentive for lower-quality facilities to improve their procedures. For one facility, the rate of heart attack following bypass surgery dropped from 2.8 percent in 1993 to 0.9 percent in 1997. A national ``Centers of Excellence'' program would likely have the same result, spurring facilities with a lower quality rating to improve their services and raising quality standards overall. Not only will H.R. 1392 improve quality, it will also lower costs for Medicare. Fewer complications after surgery mean less follow up care and fewer medical expenses. Targeting patient volume to certain facilities can also result in discounted prices. Although ``Centers of Excellence'' passed the House in 1997, political motivations have kept it from becoming law. quality health care should not be a pawn in the political chess game. We have a second chance to implement this important change for Medicare. I strongly urge my colleagues' support for H.R. 1392. ____________________