January 4, 2017

REFORM, NOT REPEAL:

A Bipartisan Reason to Save Obamacare (Tina Rosenberg, JAN. 4, 2017, NY Times)

The A.C.A. is more than insurance. As the Times reported yesterday, the law is leading a transformation of America's health care system. It's a change that nearly everyone, Republicans and Democrats, agrees is desperately needed -- and for it to happen, the relevant parts of the A.C.A. must be preserved.

The transformation moves health care away from a fee-for-service model, which pays doctors and hospitals according to the number of procedures they do, toward value-based care, which pays based on what helps patients get better. [...]

More than a third of Medicare payments to providers now depend on value instead of volume. This has already helped to hold down costs. And value-based payments will get a huge increase from a law kicking in this year that moves Medicare payments of physicians away from fee for service. The law passed with overwhelming bipartisan support -- and it can't work without the Innovation Center's projects.

Many of the experiments involve paying health care providers a set amount per patient on top of their fee-for-service reimbursement, as well as a share of the savings if they meet health care quality and savings goals.

This frees up providers to do things fee for service doesn't pay for: talk to patients about how they can take care of themselves, hire community health workers to promote behavior change, see patients by video or phone, or take on extra staff to coordinate care to avoid duplication and medical errors.

Posted by at January 4, 2017 5:22 AM

  

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