In Washington, D.C., the path from change to speculation to adaptability moves pretty quickly, evidenced in part by the lame-duck Congress moving the long-awaited and bipartisan 21stCentury Cures bill toward law before the inauguration.
Speculation on what a Trump administration will do on many fronts, particularly on ACA insurance, has for the health IT and healthcare delivery industry become focused on the future of value-based care payment models and population health management strategies upon the more recent nomination of Tom Price, MD (R-GA) as secretary of Health and Human Services.
This was the very topic of a three-day summit November 30 to December 2 hosted by the Jefferson College of Population Health and its dean David B. Nash, MD, MBA, FACP.
The summit brought together outgoing CMS Administrator Andy Slavitt, former HHS Secretary Michael Leavitt, former ONC Director Farzad Mostashari, NCQA President Peggy O’Kane, former advisors from the George W. Bush and Obama administrations, officials from Johns Hopkins, the Henry Ford Health System, Brookings, Deloitte, AMA, AHA, the American College of Physicians and many more to dissect MACRA and ponder “population health strategy under the new administration.”
Topics and predictions ranged from the Cadillac tax going the way of the DeSoto; Medicare Advantage payment models will increase; the overriding attention on ACA insurance will back-burner VBC changes buffered also by MACRA; Track1+ will itself be the savior of MACRA; and looming large is whether Medicare will become a voucher or premium support system.
It was noted that mandatory bundled payments may end, but then again bundled payments have returned nearly 3% to the Medicare Trust Fund, versus .02% by ACOs.
Former HHS Secretary Michael Leavitt sought calm. “CMMI will be challenged, but the analytics it provides are important to maintain … we need to find the balance between provider readiness and the speed to change between providers and payers … the GOP is not in lockstep … the bottom line is we don’t know.”