Senate Bill Isn’t “Better Care” for Anyone
With the release of the Senate’s “Better Care Reconciliation Act of 2017 (BCRA),” the public finally gets a glimpse of legislation crafted in utter secrecy for the past two months, and now we know why. Despite the fanfare and feigned earnestness of the upper chamber’s efforts to improve on the “mean” House-passed American Health Care Act (AHCA), the Senate bill would be disastrous for low-income families, patients with pre-existing conditions, children, and the aged, while undermining health care security for virtually everyone else....
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CBO and America’s AHCA Headache
The much-anticipated Congressional Budget Office (CBO) score of the American Health Care Act (AHCA), the GOP’s effort to dismantle the Affordable Care Act (ACA) released yesterday, indicates that the bill would cause 23 million people to become uninsured while reducing the federal deficit by $119 billion. In that sense, there is little change from their assessment of the original version of AHCA. ...
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The Bipartisan ‘Single Payer’ Solution: Medicare Advantage Premium Support For All
In my last Health Affairs Blog post, I outlined a potentially bipartisan four-step plan to move past the American Health Care Act’s (AHCA’s) disastrous framework toward a more stable, less expensive health care system. For those seeking incremental, near-term solutions, I hope those recommendations provide helpful guidance. But the AHCA’s reckless drive through the US House of Representatives has taught us something about the current status of health care politics and may have opened the window to more significant, ultimately more successful, reforms....
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100 Days of Health Care
Before November 8, no one anticipated that health care would be the predominant focus of the next president’s first 100 days. Now, let the record reflect, that is precisely what has happened. What have we learned in the process and what do we have to show for it? The latter question is easier to answer: nothing, save for considerable uncertainty and burgeoning disruption for the health care system. As for the former, Republicans have hoisted their own petard in epic fashion. ...
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What Now?: A Four Step Plan For Bipartisan Health Reform
As I concluded in my Health Affairs Blog post last Monday, it should be clearer now than ever that new steps to improve our health care system must be pursued on a bipartisan basis. In the past week, several Members of Congress and the President himself have expressed interest in finding consensus solutions to the challenges we face. Democrats, meanwhile, have responded in kind....
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With ‘Repeal, Replace’ in Ashes, Democrats Can ‘Repair’
The front-page failure of Republicans’ effort to repeal the Affordable Care Act last week has opened a remarkable and unexpected opportunity to get beyond the rhetoric of repeal and undertake a thoughtful repair of the shortcomings of our current health care system. As former staff to two of the Democratic Party’s most constructive, collaborative, and accomplished health care lawmakers of the last half century — Sens. Ted Kennedy and Max Baucus — we see last week’s legislative failure as an opportunity to explore a chance for real progress....
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Five Lessons From The AHCA’s Demise
While the keyhole of history has had insufficient time to bring the failed launch of the American Health Care Act (AHCA) into focus, it’s not too soon to begin learning some of the lessons it can teach us. Legislative efforts have a lifespan but our health care system does not. So whether we are still rejoicing or recriminating, let’s take a look at some timeless principles we can apply to the ongoing effort to improve health care in the United States. ...
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Five Reasons The ACA Won’t Be Repealed
Since November 8, a chill has descended among individuals nationwide who are involved with or otherwise care about health care. Like sheep herded to their fate, there has been a resignation that the Affordable Care Act (ACA) will be repealed, taking with it coverage for over 23 million people, strong protections for consumers, and innovations in care delivery....
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MACRA Final Rule: CMS Strikes A Balance; Will Docs Hang On?
On Friday, the Centers for Medicare and Medicaid Services (CMS) released the Final Rule implementing the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)—aka the “SGR” repeal bill, aka Medicare physician payment 3.0. The central theme of the MACRA Final Rule is its softening of key program parameters in an effort to allay provider concerns, rally participation, and avoid adverse consequences out of the gate....
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Breaking Down The MACRA Proposed Rule
The mother ship has landed. On Wednesday, April 27, the Centers for Medicare and Medicaid Services (CMS) released the highly anticipated proposed rule that would establish key parameters for the new Quality Payment Program, a framework that includes the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs)....
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Brave New World: Medicare’s Advanced Payment Models
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) established a new framework for Medicare physician payment. Under the law, beginning in 2019, health care professionals participating in the program will come to a crossroads on their path to reimbursement. In one direction—the default direction—they will be subject to the Merit-Based Incentive Payment System (MIPS), a revamp of Medicare’s fee-for-service (FFS) payment system that consolidates existing quality programs into a unified reimbursement component....
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Moops?: A Roadmap To MIPS
After a seemingly endless stream of stop-gap “doc fixes,” President Obama on April 14, 2015, signed into law a permanent repeal and replacement of Medicare’s Sustainable Growth Rate formula. The 2015 law, known as the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) (P.L. 114-10), permanently reformed Medicare physician payments and (finally) put to rest what had become a dreaded perennial legislative ritual of blocking reimbursement cuts. ...
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