It is no secret that the Department of Veterans Affairs (VA) has faced tremendous challenges providing our nation’s veterans with access to the timely, quality care they deserve.
The American healthcare system is in a state of uncertainty. And it is failing patients.
At least that’s the assessment I’ve frequently come across over the past few weeks. Roiling politics and the resulting policies seem to be the root of this uncertainty. Be it the changes ushered in by the Affordable Care Act (ACA) or the looming changes brought by the election of Donald Trump and a Republican-controlled Congress, it seems that healthcare will be in a state of flux and disarray for the foreseeable future.
“Only two things in life are certain – death and taxes.” I had a high school teacher who liked to pull out this famous quote from Benjamin Franklin every time he got an unanswerable question from some wisenheimer.
As I sat last week poring over hundreds of pages of health plan brochures trying to sort out the best option for my family, I’m reminded of this quote and can’t help but wonder if there is a third certainty in life that Mr. Franklin missed – health insurance is about as clear as dishwater.
They say that “states are the laboratories of democracy.” In no place is this more evident than the state of Vermont’s efforts to radically change their healthcare delivery system.On October 26, CMS and Vermont’s Green Mountain Care Board (GMCB) jointly announced the Vermont All-Payer Accountable Care Organization (ACO) Model. This new, first of its kind initiative is aimed at accelerating healthcare delivery reform for the entire state and its population by establishing a statewide ACO that is responsible for the health outcomes of its entire population.
With the final MACRA rule released on Oct. 14, the industry is now getting the chance to dig into all of the details of this 2,300-page document, especially the act’s Quality Payment Program, which replaces the Sustainable Growth Rate formula with two tracks of reimbursement—the Advanced Alternative Payment Models (APMs) or Merit-based Incentive Payment System (MIPS).
“Folks are now in the process of getting their heads around what’s in the final rule and determining what they have to do to respond in 2017,” said Aaron Turner-Phifer, URAC’s director of government relations and policy. “The most important thing right now is for practices and clinicians to be engaging with their medical societies and educating themselves on the best path forward.”
Commenting on the imminent release of a final rule on the Medicare Access and CHIP Reauthorization Act (MACRA), Centers for Medicare and Medicaid Services (CMS) Acting Administrator Andy Slavitt anticipated this new healthcare policy will give providers a “proliferation of opportunities.”
The final MACRA rule is expected to be released by CMS on or about November 1. It will implement the Quality Payment Program (QPP) that will replace the Sustainable Growth Rate governing Medicare reimbursements for providers treating Medicare beneficiaries. The QPP promotes value-based, coordinated care over the traditional fee-for-service method. It requires that participating practices cite progress through measures of performance.