The end of the Sustainable Growth Rate–era might be within reach as the House overwhelming passed a bill that would repeal the flawed formula, as well as extend funding for the Children’s Health Insurance Program and community health centers, and ease the transition away from Medicare’s fee-for-service model to a more value-based payment system.
But despite the 21% Medicare physician pay cut looming on April 1, the Senate showed no urgency in moving this legislation , choosing to adjourn for the scheduled 2-week spring recess without taking any action on the bipartisan bill that has also been endorsed by the White House.
Speaking of the move to value-based care, the U.S. Department of Health & Human Services kicked off its Health Care Payment Learning and Action Network , a nationwide consortium of doctors, hospitals, payers, and advocates aiming to make the transition to value-based payment models from fee-for-service a smooth and transparent one.
Meanwhile, predictions on growth in patient volume due to the Affordable Care Act’s individual mandate as well as expanded Medicaid coverage thus far have not panned out, according to a report from athenahealth. However, the increase in coverage, particularly from Medicaid expansion, has led to a drop in uncompensated care, according to data from HHS.
The ACA also has saved consumers $5 billion as insurers are spending more premium dollars on medical claims and less on administrative costs with no increases in net profit, according to a report from The Commonwealth Fund. However, insurers are spending few premium dollars on quality improvements.
To hear all that and more, please take a listen to the Policy & Practice Podcast.
gtwachtman@frontlinemedcom.com
On Twitter @PolicyPractice
