Trump administration takes aim at Obama-era Medicare program
The Trump administration on Thursday moved to tighten controls over an Obama-era health program by making doctors and hospitals take on greater financial risk for 10.5 million Medicare patients.
Seema Verma, the Centers for Medicare and Medicaid Services administrator who has been critical of the Affordable Care Act, said the changes are necessary because the Medicare program had "weak incentives" for health-care providers to slow spiraling costs.
Under proposed changes, hospitals and doctors would adhere to a more aggressive timetable to save money while maintaining quality of care. Medicare, the federal health program mainly for adults over 65, projects the changes would save the federal government $2.2 billion over 10 years.
"After six years of experience, we feel we know what works and what doesn't," Verma said. "We want to focus on delivering value for patients and taxpayers."
Verma said, without changes, that the nation is on pace to spend $1 out of every $5 on health care by 2026, an unsustainable path that will harm families, businesses and the economy.
The Obama program, part of the Affordable Care Act, encouraged hospitals and doctors to band together as "accountable care organizations" to coordinate medical care and cut down on unnecessary tests and procedures. The idea is that if these organizations could deliver care at a lower-than-projected cost, they could collect bonus payments from the federal government.
However, CMS said that 82 percent of 561 accountable-care organizations chose a risk-free version of the program that provided little incentive to reduce spending. These organizations recouped savings if they cost Medicare less than projected, but they faced no financial penalty if they billed more than expected.
The upshot: Congressional Budget Office projections that the Obama-era program would save Medicare $5 billion through 2019 never materialized.
Under Verma's changes, participants would be limited to two years in the risk-free version of the program. The current regulations allow these organizations to stay for 6 years.
The likely result will be hospitals and doctors dropping from the program.
CMS projects that nearly 20 percent of participants will drop out of the voluntary program due to the more aggressive timetable. However, an industry organization called the National Association of ACO's predicts 71 percent will drop from the program.
More at: https://www.usatoday.com/story/news/...ram/951349002/
