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HHS nominee seen favoring fellow physicians’ interests


When Medscape reported on the nomination of Tom Price, M.D., to be secretary of health and human services, an internist commenting on the story wrote, “FINALLY.”

Many physicians expect that Congressman Tom Price, M.D., a former orthopedic surgeon and longtime promoter of the economic and other interests of physicians, will, in the words of Medscape,  “rescue them from the burdens of Medicare reporting programs, the swift transition to value-based payments, and doctors’ growing inability” to make more money.

American physicians are by far the highest paid in the world.

In fact, Dr. Price is probably in the best position to make these changes and may eventually succeed, says Joe Antos, PhD, a health-policy expert at the American Enterprise Institute, a conservative think tank. But he adds that making such changes would be very challenging and could well take years to accomplish.

As HHS secretary and a physician, Dr. Price could take “a more active role” in the Centers for Medicare & Medicaid Services (CMS), which reports to HHS and creates many of the policies that concern physicians,  Joe Antos, a health-policy analyst at the conservative American Enterprise Institute,  says.

“Previous HHS secretaries often didn’t have the experience to interpret the complexities of CMS policies and regulations,” Mr. Santos told Medscape. “Price is a clear exception.”

Patrice A. Harris, M.D., chairwoman of the American Medical Association (AMA), is a psychiatrist from Dr. Price’s home state of Georgia and has known him  for 15 years. “Dr Price has always been willing to listen and to hear both sides of an informed debate,” she told Medscape.

Several commentators have predicted that Dr. Price would stop CMS’s move toward value-based payments, which reward quality and outcomes, and return to fee-for-service payments, which comprise the most lucrative system for physicians.

To read the Medscape piece, please hit this link.

UnitedHealth gets deep into primary-care innovation


David Chase, writing in Forbes’s online service under the headline “The Exchange Is Dead, Long Live the Exchange,”  says:

“Recently, headlines screamed about UnitedHealth threatening to leave the ACA exchanges. …United is losing hundreds of millions on the public exchanges. Meanwhile, virtually no one has noticed perhaps the smartest move I’ve seen any health insurer make—build a de novo value-based primary-care model from the ground up that is optimized for the consumer and small business market that the exchanges target.”

FierceHealthPayer reports that United’s wholly owned subsidiary, Harken Health, calls itself “a new kind of healthcare company that unites relationship-based primary care with flexible and competitively priced health insurance in a membership-based model” and  free primary-care visits at its clinics.

Mr. Chase points out that the venture is also a partnership with Iora Health, know for refusing to accept fee-for-service payments and  assigning patients health coaches to guide behavior.






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