Public Health, Workforce, Quality, and Related Provisions in H.R. 3962 Page: 2 of 72
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Public Health, Workforce, Quality, and Related Provisions in H.R. 3962
Summary
Health care reform is at the top of the domestic policy agenda for the 111th Congress, driven by
concerns about the growing ranks of the uninsured and the unsustainable growth in spending on
health care and health insurance. Improving access to care and controlling rising costs are seen to
require changes to both the financing and delivery of health care. Experts point to a growing body
of evidence of the health care system's failure to consistently provide high-quality care to all
Americans.
The health reform debate has encompassed a number of proposals to address these challenges and
improve the delivery of health care services. They include initiatives to encourage individuals to
adopt healthier lifestyles, and to change the way that physicians and other providers treat and
manage disease. Delivery reform proposals focus on expanding the primary care workforce,
encouraging the use of clinical preventive services, and strengthening the role of chronic care
management. Health care delivery reform relies on putting mechanisms in place to drive change
in the systems of care. Key drivers include performance measurement and the public
dissemination of performance information, comparative effectiveness research, adoption of health
information technology, and, most important, the alignment of payment incentives with high-
quality care. In February 2009, Congress enacted the Health Information Technology for
Economic and Clinical Health (HITECH) Act to promote the widespread adoption of electronic
health records for sharing of clinical data among hospitals, physicians, and other health care
stakeholders.
On October 29, 2009, Representative Dingell introduced a comprehensive health reform bill, the
Affordable Health Care for America Act (H.R. 3962). The legislation is based on an earlier
measure, the America's Affordable Health Choices Act of 2009 (H.R. 3200), which was jointly
developed and reported by the House Committees on Ways and Means, Energy and Commerce,
and Education and Labor. This report, one of a series of CRS products on H.R. 3962, summarizes
the bill's workforce, prevention, quality, and related provisions.
H.R. 3962 includes numerous provisions intended to increase the primary care and public health
workforce, promote preventive services, and strengthen quality measurement, among other
things. The legislation would amend and expand on many of the existing health workforce
programs authorized under Title VII (health professions) and Title VIII (nursing) of the Public
Health Service Act (PHSA). It would create a Public Health Workforce Corps and establish a new
loan repayment program, modeled on the National Health Service Corps (NHSC), for individuals
who agree to practice in medically underserved areas with unmet health care needs. The bill also
would make a number of changes to the Medicare graduate medical education (GME) payments
to teaching hospitals, in part to encourage the training of more primary care physicians.
In addition, H.R. 3962 would bolster quality improvement activities, including performance
measurement, and broaden Medicare and Medicaid coverage of clinical preventive services. The
legislation would establish a multi-billion dollar Public Health Investment Fund to provide
additional funding for these and other new programs and activities.Congressional Research Service
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Redhead, C. Stephen. Public Health, Workforce, Quality, and Related Provisions in H.R. 3962, report, November 5, 2009; Washington D.C.. (https://digital.library.unt.edu/ark:/67531/metadc821068/m1/2/?q=food+rule+for+unt+students: accessed June 12, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; crediting UNT Libraries Government Documents Department.