Want to run the government like a business? Bring back the ACA.

Just days after his inauguration, President Donald Trump signed an executive order to delay further implementation of the Patient Protection and Affordable Care Act (ACA). This is just one of many steps the President and Congress plan to take in an effort to repeal the ACA. It sounds simple – just a few strokes of a pen and this behemoth of a law will disappear into history. But will it? Aside from the individual mandate and Medicaid expansion, two of the most famous and controversial pieces of the ACA, there are countless others. The ACA itself required the creation of nearly fifty new entities, with each of those entities authorized to implement other new entities or programs. For example, the ACA authorized the creation of the Center for Medicare and Medicaid Innovation (CMMI), which has created over eighty innovation models with the goal of increasing the quality and efficiency of patient care while decreasing the cost. This new relationship between cost and quality in health care is termed “value based purchasing,” and it is an idea that has taken root beyond the reaches of the ACA. Over 65% of the … Continue reading

Posted in Affordable Care Act, Private Payors

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If Obamacare’s Days are Numbered, What’s Next? Trumpcare.

The Affordable Care Act has withstood 62 repeal attempts by the House of Representatives and several challenges brought to the U.S. Supreme Court.  Now, with Donald Trump as President and a new Republican-led House and Senate, full or partial repeal of the ACA seem likely to occur sometime in 2017, perhaps with a delayed effective date.  What impact would an ACA repeal have on healthcare industry?  Is a full repeal possible?  What are the potential varieties and timing of any replacement “Trumpcare” programs?  Below are some of our initial thoughts on some of these questions. Provider uncertainty ahead. Several stock analysts have expressed concern that successful repeal of the ACA would have a negative financial impact on health care providers and that any replacement would not be as lucrative for providers.  The first immediate impact after the election of Trump was a sharp decline in stock prices for some healthcare services companies, although some medical device and pharmaceutical companies saw a rise in stock prices, presumably on theory that less regulation would be better for their businesses.  MACRA was the result of bi-partisan consensus to move into alternative payment models … Continue reading

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