Pelosi offered a key policy change to the “Medicare plus 5 percent” option being pushed by the Progressive Caucus and other liberal members.
Rural members have been irritated that the “plus 5 percent” went only to physicians, not hospitals. Hospitals under the “robust” option would be reimbursed at Medicare rates.
This concession reduces the cost saving potential of the public option by roughly $20 billion. It is hoped that this will help win over Democrats representing rural districts that complain Medicare reimbursement rates are too low in rural areas.
Perhaps the more important "concession" from Pelosi, however, was acknowledging that a robust public option might not make it out of conference:
She said that if House Democrats pass the public option liberals support, they could ultimately have the more centrist version of the provision when the final bill is hashed out in conference with senators, according to some of those in attendance.
By passing this more robust version of the public option in the House, it should increase the likelihood that a final compromise with the Senate would include the weaker (but still national and available on "day one") “level playing field” public option favored by some blue dogs. I suspect this acknowledgment was more critical than a modification to the payment rates for hospitals to winning over some conservative Democrats.