Medicare payment reform now finds itself among the many issues the status of which are up in the air as the dust settles from Tuesday's presidential election.
The Obama administration has been grappling with reforming Medicare reimbursement policy to attempt to insert the value concept into payments. While such efforts had met with strong opposition from physicians and their lobbying groups, the reform had solid bipartisan support in Congress. Thus the reform effort appeared to be immune from GOP meddling.
Not so fast, says a report in Modern Healthcare. With physicians not just carping, but also announcing plans to retire early from practice or refuse to see Medicare patients, Trump and his supporters could decide to tackle the value-based system.
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"Experts are mixed about whether those sentiments would be enough to get the Republican-led Congress and the incoming Donald Trump administration to slow Medicare's march away from fee-for-service medicine to a value-based system," reports Modern Healthcare.
The publication, quoting a UnitedHealthcare vice president, suggests the anti-value-based campaign by physicians could well be taken up in the GOP-dominated Congress — but perhaps through a procedural rather than up-and-down reversal move.
The strategy would be "to slow implementation of [Medicare Access and CHIP Reauthorization Act] until [Republicans] can assess how many physicians would leave Medicare or the profession because of the law," Modern Healthcare says.
The Medicare Access and CHIP Reauthorization Act lays out four performance categories (quality, resource use, clinical practice improvement and advancing care information) that physician reimbursements will be based on. Physicians have said compliance with the act will be an administrative nightmare, one so onerous that many will leave their practices or dump Medicare business rather than comply.
While some industry observers may believe a Trump government will wade into the reform waters, others told Modern Healthcare that the strong across-the-aisle support for the value-based system will likely trump any effort to support the physicians' position.
"This is not an area that is up for debate," one source told Modern Healthcare. "It's clear that value is the new health economy and measures are the currency."
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
