Iowa Senator Charles Grassley heard a clear, unified message from the state’s hospital leaders at a meeting in Des Moines this week:  stay at the health care reform negotiation table and fight to fix geographic variation in Medicare payment.  Grassley, who is one of six key Senators negotiating language for that chamber’s reform bill, said he is committed to including that fix in the final bill and will “be at the table until I am pushed away.”

At the same meeting, the American Hospital Association (AHA) backed the IHA-formulated plan to address Medicare geographic variation through value-based purchasing.

Meeting with more than 30 hospital CEOs and other executives at Des Moines University, Grassley told the group he wants to understand the priorities of Iowa hospitals.  “I appreciate the help we get from AHA and the work they do, but I am much more interested in how you folks see it,” Grassley said.  “I want to be able to gauge the progress of addressing your ideas.”

Over the course of the hour-long discussion, Grassley heard several concerns related to health care reform and its impact on Iowa hospitals, including the need to address Medicare payment issues for “tweener” hospitals through a low-volume adjustment and reauthorization of the Medicare Dependent Hospital program.  Grassley said Iowa hospitals have done a great job of keeping the “tweener” issue in the forefront, noting that he now had the names of the impacted hospitals memorized.

The meeting with IHA members was one of the last for Grassley before he returns to Washington, D.C. to resume work on the health care reform legislation.  Having spent most of August hearing the concerns of Iowans at well-attended town-hall meetings, Grassley said his faith in grass-roots democracy has been revived.  He also noted he consistently heard from hospital representatives at those forums.

“For the most part, Iowans can be proud of how they conducted themselves at those meetings,” Grassley said.  “A lot of what we saw on the media didn’t reflect what I saw here in Iowa.”

Developing more specific proposals and finalizing legislation will be difficult over the next three months, said Grassley, who reiterated his commitment to a bipartisan bill.  “There are a lot of unknowns out there,” he said.  “Maybe we’ll know after the president speaks next week,” he added, referring to President Obama’s speech on health reform before a joint session of Congress on September 9.

The last time a president addressed a joint session of Congress that wasn’t a State of the Union or the traditional first address by a new president was when President George W. Bush spoke about the war on terrorism following the 9/11 attacks.

Have thoughts about the health care reform debate and how it is impacting Iowa?  Leave your comments below.