Washington Debrief: Texas Rep. Wants to Nix ICD-10

According to Washington observers, Congress may be reaching an “inflection point” in healthcare.  There appears to be growing consensus around a series of granular policy recommendations meant to transition healthcare payment away from fee-for-service.  Two reports in particular, one from the Bipartisan Policy Center and the other from Brookings Institution, clue-in on the next iteration of Accountable Care Organizations.  The BPC calls them Medicare Networks and Brookings refers to them as Medicare Comprehensive Care (MCC) organization, but the idea is the same: encourage seniors to enroll in the care delivery organizations (similar looking to ACOs) by allowing the beneficiaries to share in the savings derived through coordinated care.  Other similarities between the plans include: rewarding beneficiaries for using MCCs; making Medicare Advantage plans bid against one another; replacing the Medicare physician pay formula; eliminating Medigap first dollar coverage along with capping catastrophic liability; ending the tax exemption for employer-provided health insurance; and sharing more Medicare savings with states. Both plans are estimated to save Medicare $300 billion over 10 years, which includes the cost of replacing the Sustainable Growth Rate (SGR) formula that determines physician pay rates.

Edited by Gabriel Perna