HHS nominee favors big revamps of Medicare, Medicaid

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President-elect Donald Trump on the campaign trail railed against the Affordable Care Act, promising to repeal and replace it.

While Trump has waffled since the election on plans to completely repeal the ACA, he has now nominated a strong ally, Republican congressman and physician Tom Price of Georgia, as Secretary of the Department of Health and Human Services, to get the job done.

Observers note that Price’s views on revamping healthcare reform initiatives could have a trickle-down effect to emerging strategies in place for healthcare information technology, as uncertainties in reimbursement incentives could stall HIT spending.

Also See: GOP eyes lighting strike on Obamacare to kick off Trump era

Price is chair of the House Budget Committee and a respected member of Congress. However, despite the experience in government, he’ll be on a steep learning curve in his new role, since he has no executive experience, nor any experience in running a government agency.

Price, an early supporter of Trump during the campaign, is a committed opponent of the Affordable Care Act, and he’s publicly stated that he wants to go beyond tinkering with the ACA.

Price has come out in support of changing Medicare and Medicaid from entitlement programs into block grant programs, under which states would have more say over eligibility rules and medical services to be covered. Under his plan, the government would give older and disabled persons now on Medicare financial help to buy private insurance policies.

Price opposes value-based reimbursement policies that take into account the quality of care and outcomes, and he believes that the government had no authority to institute mandatory bundled payments, according to an article in Forbes.

His policies have raised immediate concerns from groups concerned about rollbacks in coverage or changes in reform initiatives that are just beginning to emerge.

“The pending nomination of Price as Secretary of Health and Human Services could have major consequences for the 20 million Americans who currently have coverage under the Affordable Care Act,” says Ted Chan, founder and CEO of CareDash, an online healthcare portal for consumers to access and review their physicians.

“Any new policy must sufficiently address how to control rising health insurance costs without thrusting the middle class back into a healthcare system without adequate and affordable coverage,” Chan added. “It will also be critical to have a transition and policy replacement plan in place so that the costs of covering the uninsured are not once again absorbed by hospitals, employers and insured consumers.”

Price has been a champion of physician concerns in the Congress; those concerns are why he entered the political arena. Price and Rep. Phil Roe of Tennessee, also a physician and chair of the Congressional Doctors Caucus, in October sent a letter to the Centers for Medicare and Medicaid Services and the Office of Management and Budget taking issue with implementation of the MACRA Act and concerns that physicians have with a new payment system starting in January 2017.

The lawmakers urged policymakers to develop a less burdensome physician reporting system under the Merit-based Incentive Payment System with a scoring system that is simple and has attainable thresholds, lower patient minimum reporting thresholds to reduce administrative burdens on small providers, broadening of the MIPS exclusion for physicians who treat a low number of Medicare patients, and speeding up MIPS assistance to small practices, which currently is not expected until 2018.

Sen. Lamar Alexander (R-Tenn.), chair of the health committee, noted Price’s experience in physician issues as a key attribute he’ll bring to the HHS position. “Dr. Price has a thorough understanding of healthcare policy and the damage that Obamacare has caused—he can see the view from the doctor’s office, as well as from the lawmaker’s office. I look forward to working with him to find a responsible way to replace and then repeal Obamacare so we can move most healthcare decisions out of Washington and back to states and patients.”

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