December 7, 2009

The Honorable Mark Warner

United States Senate
459A Russell Senate Office Building
Washington, D.C. 20510

Re: Freshman Cost Containment Amendment

Dear Senators,

On behalf of Gundersen Lutheran representing clinics and hospitals in Wisconsin, Iowa and
Minnesota, we extend our appreciation for your ongoing efforts to find solutions to reduce the cost
of health care while improving the care provided to Americans. Gundersen Lutheran endorses
health reform efforts that reward high quality care for all Americans. To that end we believe the
ability to improve community health will be the true measure of successful healthcare reform and
provide the highest return on healthcare expenditures. On behalf of Gundersen Lutheran, we
support your sponsorship of the Freshman Cost Containment Amendment to the Patient Protection
and Affordable Care Act.

Health reform legislation must address the rising costs of health care by comprehensively changing
the way we deliver and pay for health services. The current Medicare payment system rewards
volumes which results in overutilization of services without improving health outcomes. Moving
payment in this direction will allow Medicare to stem the costs associated with unnecessary care and
remain solvent for future generations. Your amendment challenges Medicare to become the leader
in moving to a value-based payment system with action, encourages collaboration with the private
sector, and seeks to streamline red tape to reduce administrative costs.

This amendment goes beyond setting up a value-based payment structure in Medicare. The
Freshman Cost Containment Amendment also encourages collaboration with the private sector on
quality measures and outcomes. Finally, the amendment also addresses administrative costs and the
red tape involved in the healthcare industry. Every dollar spent on onerous and duplicative
administrative tasks is a dollar away from patient care.

On behalf of Gundersen Lutheran, we support the Senate Freshman Cost Containment

Amendment and we thank you for your efforts to address these critical issues. Your leadership and
ability to champion these efforts will improve the care for Americans. Please contact us if we can
help you in any way.

Sincerely,

Jeff Thompson, M.D. Joan Curran

Chief Executive Officer Chief Government Relations and External Affairs Officer
External Affairs Department 1900 South Avenue, H02-009 La Crosse, WI 54601
Email: ExternalAffairs@gundluth.org Phone: 608-775-1400 Fax: 608-775-6225
Cc: Senator Al Franken (co-sponsor)
Senator Tom Udall (co-sponsor)
Senator Mark Udall (co-sponsor)
Senator Michael Bennet (co-sponsor)
Senator Mark Begich (co-sponsor)
Senator Jeff Merkley (co-sponsor)
Senator Jeanne Shaheen (co-sponsor)
Senator Kay Hagan (co-sponsor)
Senator Paul Kirk (co-sponsor)
Senator Roland Burris (co-sponsor)
Senator Ted Kaufman (co-sponsor)
Senator Russ Feingold
Senator Herb Kohl
Senator Tom Harkin
Senator Amy Klobuchar
Senator Chuck Grassley

External Affairs Department 1900 South Avenue, H02-009 La Crosse, WI 54601

Email: ExternalAffairs@gundluth.org Phone: 608-775-1400 Fax: 608-775-6225