As Donald Trump was sworn in as the 45th U.S. president, health policy experts share with Managed Healthcare Executive what’s next for healthcare.
“Nearly every president since World War II has attempted to influence and improve healthcare, and the recurring theme tends to be expanded access and affordability, with an increasing focus on quality in recent decades,” says Dan Renick, RPh, president, Precision for Value.
“President Trump appears poised to attempt similar given his campaign focus on repealing and replacing Obamacare, but changes will likely be more measured than massive, even with a legal repeal of the Affordable Care Act [ACA],” Renick says. “The theme that this administration will likely expand on significantly is value demonstration, including payment reforms, that effectively incorporate value into fair reimbursement.”
Here are 5 things to expect:
1. Focus on ACA repeal with a longer rollout of replacement policies. “The Administration’s principal healthcare agenda will be to roll back policies of the ACA,” says Anders Gilberg, senior vice president, government affairs, Medical Group Management Association (MGMA). “But replacement will prove to be a difficult balancing act between preservation of popular policies and the desire of Congress to do so in a fiscally conservative manner.”
As this is a big undertaking, Matthew Hutt, CPA, CGMA, partner, AAFCPAs in Boston, doesn’t expect to see changes overnight. “We expect that they will keep the things that people generally like, such as kids being able to maintain coverage on their parents’ plan until they are 26, and coverage for Americans with a pre-existing condition—both did not exist before Obamacare,” Hutt says. “Even if the ACA is modified, the model will still likely follow quality versus quantity when it comes to reimbursements. The fee for patient care will be paid for as a shared responsibility for the patient’s overall healthcare. This is a widely accepted methodology to control the costs of healthcare, and to ensure long-term care recovery and better clinical outcomes.”
Along with the effort to retain popular aspects of the ACA, new measures will be introduced that attempt to further expand coverage “given that 30 million Americans remain uninsured, expand the healthcare provider base to adequately provide needed care, especially primary care, and foster increased competition across healthcare to pressure price and improve quality,” Renick says.
The challenge for the former president Obama was that his plan relied heavily on his initial pick for Secretary of Health and Human Services, Senator Tom Daschle, according to Alan Portela, CEO at AirStrip. "Not getting his pick created a domino effect that ended up with poor execution and losing the election for the Democrats," Portela says. "Today, we have a president that has serious business experience and is known for his ability to execute and create strong teams around him. Repealing Obamacare and offering a comprehensive replacement plan will depend on the ability to have Rep. Tom Price’s nomination approved as the first doctor to run HHS since 1992, and close collaboration with Speaker of the House Paul Ryan."