Affordable Care Act, Medicare payments among issues Price would face
As health care issues took center stage in Washington Wednesday, physicians and policy experts are evaluating the nomination of Rep. Tom Price (R-GA) as secretary of Health and Human Services.
But while the future of the Affordable Care Act was the hot topic of conversation on Capitol Hill, it is Price’s potential approach to entirely different legislation that is also of deep interest to the medical community: Medicare and how payments are reimbursed.
Under the Medicare Access and CHIP Authorization Act (MACRA), a new rule finalized in October moves an already disliked fee-for-service system to value- or merit-based payments, and includes new reporting requirements.
Some doctors have expressed concern at the continued layers of bureaucracy contained in the new Centers for Medicare and Medicaid Services rule. It is here that physicians and health care experts believe Price, a practicing orthopedic surgeon for decades before entering Congress, will be an asset for doctors.
According to the American Medical Association (AMA), Price has followed every step of the rule-making process.
“We are deeply concerned about how this rule could affect the patient-doctor relationship, and I look forward to carefully reviewing it," Price said in a statement in October, when the finalized rule was announced and long before he could have thought of being the next nominee to be Health and Human Services secretary,
Price has the experience and is in a position to make changes to the Medicare system, but it will be difficult, according to Joe Antos, a health policy expert with the American Enterprise Institute think tank. But Antos told Patient Daily he believes there will be a large-scale exodus by doctors from delivering Medicare services in the shorter term.
“Many doctors are not close to retiring or they are not established enough to drop Medicare altogether,” Antos said. “Many do not have the volume.”
While the MACRA rule is not a good one, it is incorrect to state doctors will drop Medicare as, for many, it is “just too big a part of their business,” Antos said.
One report by the Kaiser Family Foundation and Commonwealth Fund, basing its number on the 1,257 physicians responding to a survey, estimated 200,000 will not accept new Medicare patients. Another survey published last year by Medscape Medical News found that 36 percent of physicians believe large numbers of their peers will drop Medicare patients.
“The No. 1 reason for me opting out of Medicare was, and is, the bureaucracy," Dr. Rebekah Bernard told Patient Daily. "I just do not feel comfortable working in a system that creates a negative environment and feels punitive.”
As an organization, the AMA enthusiastically endorsed the nominee, noting in a statement that it hoped he would “reduce excessive regulatory burdens that diminish time devoted to patient care and increase costs."
"Dr Price has always been willing to listen and to hear both sides of an informed debate.” AMA Chair Patrice A. Harris told Medscape Medical News.
But there are dissidents within the medical community, and more than 750 members of the organization penned a letter to its board objecting to the warm endorsement, according to the New York Times, which outlined the fears of some doctors that he will help dismantle the Affordable Care Act.
Organizations in this story
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