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Dissent in the AMA

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Dissent is increasingly roiling the American Medical Association, which once had 75 percent of physicians as members but now  has fewer than 25 percent.

The debate includes the incoming Trump administration’s vow to kill the Affordable Care Act and its nomination of vehemently anti-ACA ex-orthopedic surgeon Tom Price, M.D., a Georgia congressman, to be the next secretary of health and human services. It also includes such issues as Republican plans to turn the federal side of Medicaid into entirely a system of  block grants to the states and to defund Planned Parenthood.


Group pleads with Trump to maintain value-based direction

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In a letter sent this week, the Health Care Transformation Task Force is asking the Trump administration to continue efforts to replace fee-for-service payment models with value-based care.

The group, which includes patients, payers, providers and purchasers, says  that payment and care-delivery innovation have been supported on a bi-partisan basis and asked that President-elect Donald Trump, Vice President-elect Mike Pence and congressional  affirm that the support will continue.

“Given the significant industry investment and strong progress to date, we urge the new Administration and Congress to send signals of support and encouragement so this transition can be sustained. This is not the time for policymakers to waver or reverse course, which would send a negative message to the industry and chill ongoing transformation efforts,” the task force wrote.

The group  said that sustainable value-based payment models depend on  “aligning private-sector and public-sector efforts.” And they lauded the Center for Medicare & Medicaid Innovation as a public-sector entity that has dramatically advanced payment and care-delivery transformation. But many Republicans have vowed to kill that institution.

A challenge: Many very highly compensated physicians, especially specialists, and other affluent providers and healthcare executives, seem to have the ear of the very rich folks who will be running the federal government under Mr. Trump. They will push back hard against anything that might reduce their personal and institutional incomes.

An example is Tom Price, M.D., a rich former orthopedic surgeon who implied that he’d fight anything that would curtail incomes of U.S. physicians, who are by far the highest paid in the world. These groups have hugely benefited from the traditional fee-for-service system — a system that encourages vast amounts of waste and duplication and produces among the worst  population-health metrics in the Developed World.

To read the letter, please hit this link.


Trying to make sense of Ryan’s Medicare reform

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Herewith some points to help understand House Speaker Paul Ryan’s proposal to overhaul Medicare:

His plan calls changing the program so that individuals eligible for Medicare would get a fixed contribution from the Feds to put toward buying private insurance.

The idea is to boost payer competition and encourage more cost- consciousness in beneficiaries as they select plans.  The hope is that giving beneficiaries  a choice of various health plans will lead payers to offer more competitive prices, leading to lower premiums.

Many Republican senators have said that they want to focus on “repealing” the Affordable Care Act and not touch Medicare for a year.  But the tricky thing is that the ACA is interwoven with Medicare.

Meanwhile, Democrats senators strongly oppose privatizing  Medicare.

And President-elect Trump  himself may also present an obstacle for Medicare changes, which could be very, very unpopular with many voters. In the past, he has said that he would not cut Medicare, Social Security or Medicaid. Of course, he says wildly conflicting things all the time, so who knows?

His transition Web site includes a promise to “modernize Medicare, so that it will be ready for the challenges with the coming {it is actually already underway} retirement of the Baby Boom generation — and beyond.” His nomination of Tom Price, M.D., as secretary of health and human services, might signal Medicare reform; Dr. Price has said that Republicans could push Medicare reform through a “fast-track budget procedure” to  would void a Democratic filibuster.

But are they willing to take the heat from millions of elderly people if they do?

 


5 reactions to HHS and CMS nominees

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Becker’s Hospital Review asked five figures in the healthcare industry for their reactions to President-elect Trump’s selection of Georgia Congressman Tom Price, M.D., to be secretary of the Department of Health & Human Services and Seema Verma, founder and CEO of health-policy consultancy SVC, to be administrator of the Centers for Medicare & Medicaid Services (CMS).

Ted Shaw, president and CEO of the Texas Hospital Association:


Trump’s nominees to lead the national conversation on healthcare both have long careers in health policy. Their depth of understanding of complex health policy issues will be essential as Congress debates the future of healthcare reform and states continue their work to more effectively manage their Medicaid programs.”

Chip Kahn, president and CEO of the Federation of American Hospitals:


The Federation of American Hospitals congratulates Chairman Tom Price on his nomination to be HHS Secretary.

“His decades of experience in the medical field make him uniquely qualified to confront the challenges facing patients, families, and caregivers. As chairman of the Budget Committee, he has proven to be a thoughtful, detail-oriented legislator who cares deeply about public policy. In light of expected legislative action on the ACA, it is noteworthy that his repeal and replace proposal recognizes the need to protect access to hospital care for millions of Americans by restoring deep Medicare and Medicaid cuts. ”

“President-elect Trump’s selection to lead CMS, Seema Verma, has a solid reputation as an effective innovator in assisting states in reforming and modernizing Medicaid programs for low-income Americans.”

To read the whole piece, please hit this link.

Donald W. Fisher, president and CEO of AMGA:
“AMGA offers its congratulations to Rep. Tom Price (R-Ga.) on his nomination to become the next secretary of the United States Department of Health and Human Services. From his experience as a practicing physician for nearly 20 years and his leadership on the House Ways and Means Committee, House Budget Committee, and the House GOP Doctors Caucus, he brings a wealth of clinical and policy expertise.”

Bruce Siegel, M.D., President and CEO of America’s Essential Hospitals:


Ms. Verma “offers a deep understanding of healthcare delivery and policymaking and can contribute an important state-level perspective on Medicaid, insurance and public health.”

Jodi Magee, president of Physicians for Reproductive Health:


“President-elect Trump’s plan to nominate Rep. Tom Price (R-Ga.) to be the Secretary of Health & Human Services (HHS) signals an alarming direction for reproductive health. Price has been a staunch opponent of women’s health and the Affordable Care Act during his time in Congress.

“Although Price has insisted that ‘patients, families and doctors should be making health decisions, not Washington, D.C.,’ he has directly contradicted that by supporting legislative efforts that interfere in the patient-doctor relationship. For example, Price has voted for anti-choice legislation that would harm our doctor’s patients, including bans on abortion, defunding Planned Parenthood and repealing the Affordable Care Act. We are deeply troubled that Price, though he is a physician, seems to disregard the strong medical evidence that access to safe and legal abortion and contraception protects not just a woman’s health, but that of her family and community.”

To read the whole piece, please hit this link.


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