There remain questions on how Gov. Rendell's health care plan will work, but health care and insurance professionals brought their suggestions to yesterday's hearing of the state House Insurance Committee at Chatham University on House Bill 700.

	VWH Campbell Jr., Post-Gazette Highmark officials, from left, Michael G. Wafel, vice president, government affairs; Deborah L. Rice, senior vice president, regional accounts, and Dr. Michael A. Madden, medical director, medical performance management, appear before the state panel yesterday. Click photo for larger image.

In the second day of testimony, representatives of the region's dominant insurer, Highmark, told legislators that their company aims to meet the demands of the marketplace and is willing to work with other private insurers and the state to achieve that goal.

That means quality of care, patient safety, keeping consumers informed and health prevention and wellness programs, said Deborah L. Rice, senior vice president of regional accounts at Highmark. "Expanding health care coverage remains a priority," she said.

For example, to raise the quality of care and control costs, she said Highmark has shared preventive information to providers in the case of diabetes treatments, and encourages better care with a pay-for-performance program. That links payments to improved outcomes, in managing asthma or reducing hospital-acquired infections, for example.

Dr. Michael A. Madden, medical director of Highmark's Medical Performance Management, said there is a financial incentive for cutting down on medical errors: "We are investing so in the long run we will have lower costs."

Rep. Dan Frankel, D-Squirrel Hill, said he wondered how much money is saved by preventive health measures, such as screenings for cancer. Dr. Madden said cost-effective analysis is a strong part of good health care. "I do not share the opinion that hospitals benefit from poor care."

Ms. Rice said private-sector programs could encourage healthy lifestyles, another cost-saving mission. Now, she said, issues such as obesity and smoking cost $5 billion in the state each year.

Providing a perspective from studying other states' health care reform proposals was Judith Solomon, senior fellow at the Center on Budget and Policy Priorities in Washington, D.C.

Ms. Solomon said legislators should be cautious about picking out pieces of Rendell's proposal and added that it needs to cover all Pennsylvanians, not just those at high risk of health problems.

She pointed out the importance of tapping $90 million in unspent federal funds from the disproportionate share hospital, or DSH, program that funnels Medicaid dollars to hospitals serving a large portion of low-income people.

She urged the state to ask for a waiver to allow these funds to be used, and matched by state adultBasic funding, to support the governor's plan to insure more adults. The plan calls for spending $104 million in federal funds, Ms. Solomon said.

An outdoor gathering, held before the hearing began, featured leaders of several Pittsburgh area groups who urged support for the governor's plan.

Citing the importance of affordable, quality health care for Pennsylvanians, a letter from the group coalition to the state legislators said, "The Prescription for Pennsylvania would reduce health care costs and, we believe, slow the growth in insurance premiums that continues to force more employers to drop coverage and swell the ranks of the uninsured."

Signers of the letter include representatives of Consumer Health Coalition, Mon Valley Unemployed Committee, Paraprofessional Healthcare Institute, Pennsylvania Budget and Policy Center and the state council of the Service Employees International Union.