Healthcare in the Time of Trump
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Transcript of Healthcare in the Time of Trump
How Will This Man Impact Healthcare?
The ACA MACRA
MIPS Value Based Medicine
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Healthcare in the Time of Trump
What we know.
What we think we know.
What we know we think.
Healthcare in the Time of Trump
The Affordable Care Act- Trump’s Words
- Trump’s Actions - Surrounding
Circumstances
MACRA/MIPS
- How will it be
Affected?
Value Based Medicine- Are we still on
Track?- Next Steps
What We Know
Along with a lot of uncertainty, there are some things we do know:
• The Surrounding Circumstances • Trump’s Words• Trump’s Actions
We Know:Healthcare is Important
Healthcare
Survey* says:
* According to Reuters/Ipso 1,800 people surveyed; (healthcare 21%, 16% jobs, 14% immigration)
We Know:Trump has a 7 Pt. Plan
1. Repeal/replace Obamacare2. Allow health insurance to be purchased across
state lines3. Individuals can deduct insurance premium
payments from taxes (just like businesses)4. Tax-free Health Savings Accounts5. Price transparency from practices, providers, and
hospitals6. Medicaid should be handled on a state level
(not federal) 7. Allow U.S. citizens to purchase drugs overseas from
overseas providers
“I do not think [Obamacare is] constitutional.”
“We have to repeal it and replace it with something less expensive.”
“Obamacare can’t be reformed, salvaged, or fixed. It’s that bad.”
We Know:Trump’s Pushing to Make ACA Changes
Seema Vera (CMS) • HIP 2.0 (Healthy Indiana Plan)
Participants make a monthly contribution or receive a lockout• Medicaid expansion
We Know:What Trump Has Done
Tom Price (HHS) • One of few with a detailed replacement plan Tax credits, Health Savings Accounts, employer limits, high-risk pools • 4 times introduced own legislation to replace ACA • Chief Sponsor of the only bill to reach White House
Appointees
The House has ALREADY voted in excess of
50 times to repeal all or parts of the Affordable Care Act!
We Know:Surrounding Circumstances
Pre-existing conditionsTrump says: “Yes. that happens to be one of the strongest assets.”
Children on parents’ plan until age 26Trump says: “We’re going to very much try to keep
that.”
Total number of insuredTrump says:
“I’m going to take care of everybody. I don’t care if it costs me votes or not.” “Everybody’s got to be covered; this is an unRepublican thing for me to say.”
We Know:Micro-perspective
MACRA/MIPS
• MACRA is separate legislation from the ACA
• MACRA may be tweaked, but the core should remain
• “Pick Your Path ...Now1. Don’t Participate = - 4%2. Submit Something = 03. Submit Partial Year = $4. Submit Full Year = $$$
• Put your process in place to track the 4 Categories
Value Based Reimbursement:
Value based reimbursement has received widespread bipartisan support
New program will focus on• Patient needs• Patient satisfaction• Minimizing costs• Rewarding providers who innovate and execute
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Prepare for Value Based Medicine
Invest in a Population Health Management tool to• Normalize patient data from multiple sources• Identify high costs and patient groups• Automate patient outreach
Focus on maximizing bonus payment opportunities• MIPS• Increased Risk Contracts with Payers• Shared Savings Programs
What You Need To Do
MIPS Readiness Assessment
The MIPS assessment is a report card that looks into a customer’s database and assesses whether or not they have the correct setup to be ready for MIPS.
State of the Practice Review
• Detail of Accounts Receivable
• Payers and Self-pays by Volume
• Existing and Potential Denials
• Automation and Tasking
• Patient Scheduling • Clinical Workflow
CareOptimize Analytics
www.careoptimize.com