As HHS secretary Tom Price begins his tenure, the ACA and physician reimbursement are on constituents’ minds.
Concerns range from the future of the Affordable Care Act, which President Trump pledged to repeal in a January 2017 executive order, to specifics of new physician reimbursement programs resulting from MACRA (Medicare Access and CHIP Reauthorization Act of 2015).
In a news release from the American Association of Nurse Practitioners, America’s leading nursing organizations called on the Trump administration and Congress to prioritize patient health and the patient-provider relationship in any health reform proposals. Representing over 3.5 million nurses, the organizations affirmed their shared commitment to advancing patient-centered healthcare and healthcare policies that reflect five key areas ranging from ensuring patients access to healthcare with affordable coverage options regardless of preexisting conditions to creating greater efficiency in the Medicare system.
On the patient side, I Am Essential, a coalition of more than 200 patient groups, asked Price to preserve key ObamaCare protections, including one that guarantees coverage for those with pre-existing conditions.
In its letter, the coalition said certain ObamaCare provisions have provided improved access to care to millions living with chronic and serious health conditions.
“While it is not a perfect law,” the letter stated, “The ACA has provided health coverage and improved access to care for tens of millions of Americans living with chronic and serious health conditions, many of whom were previously uninsured or underinsured. If they lose access and coverage for even one day, their health and well-being can be immediately jeopardized.”
The letter concluded with the following statement: “As you make any changes, we urge you not to go back on the promise of affordable and quality care and treatment for everyone, especially those living with chronic and serious health conditions.”
Meanwhile, a letter from the Medical Group Management Association (MGMA), which represents more than 18,000 U.S. healthcare organizations in which 385,000 physicians practice, asked the new administrator to “significantly reduce the regulatory burden on physician practices and improve the quality and efficiency of healthcare delivery in this country.”
Focused on the federal payor’s new Quality Payment Program resulting from MACRA, the MGMA requested the following from Price, who worked in private practice as an orthopedic surgeon for nearly twenty years prior to launching his political career:
- A reduction in the cost and reporting burden of the Merit-Based Incentive Payment System (MIPS);
- A careful review of the eligible Advanced Alternate Payment Program (APM) risk standard and contend there is significant inherent risk in moving from fee-for-service to risk-bearing arrangements, including substantial investment and operational costs, as well as misaligned financial incentives between the payment systems; and
- Legislative relief from the Federal Physician Self-Referral Law, which MGMA referred to as “a regulatory monster of mind-numbing complexity.”
MGMA represents physician groups of all sizes, types, structures and specialties, and has members in every major healthcare system in the nation.
And finally, the American Academy of Actuaries released three new issue briefs examining a number of key public policy considerations policymakers should weigh when evaluating specific proposals for reforming or replacing the Affordable Care Act.
The three papers, which address high-risk pools, selling health insurance across state lines, and association health plans, are available on the academy’s site.
“Differences in a reform’s structure can have wide implications for stakeholders and for how it interacts with other reforms that have been or may be adopted,” said Academy Senior Health Fellow Cori Uccello. “For example, high-risk pools can be structured in different ways, with different implications for access to coverage, premiums, and government spending. Further, how regulatory authority is defined for both cross-state insurance sales and association health plans affects whether insurers would compete on a level playing field.”
