Congress Agrees: Change How Healthcare Providers Get Paid

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It may be too early to hold hands and sing “Kumbaya,” but leadership in the House of Representatives and Senate for once agree on something: We must change the way Medicare pays health providers.

In two committee hearings, in the House last week and the Senate on Tuesday, the consensus appears to be that the time has come to do away with fee-for-service and the Sustainable Growth Rate (SGR). At yesterday’s hearing of the Senate Finance Committee, Chairman Max Baucus (D-Mont.) said the time had come for both payment models to go. “We must permanently repeal this broken formula and we need to do it this year,” he said.

“We know this is not an easy task,” said Senator Orrin Hatch (R-Utah), “but physicians and patients deserve better. We must find a more stable foundation to pay physicians treating Medicare patients.”

The Senate also agreed with the Obama administration yesterday by ratifying the appointment of Marilyn Tavenner to service as director of the Centers for Medicare and Medicaid Services (CMS). Tavenner becomes the first permanent director since the last one resigned in 2006, and won her job by a 91-7 vote.

The love-fest in Congress pretty much ends there. The House today will vote once again to repeal the Patient Protection and Affordable Care Act. Depending upon who you ask, this is either the 37th or the third attempt to stop Obamacare. “Albert Einstein defined insanity as follows: doing the same thing over and over again and expecting different results,” said Senate Majority Leader Harry Reid (D-Nev.) yesterday on the Senate floor. “If his definition is true — and I won’t argue with Einstein — then House Republicans have truly lost their minds.”

House Republicans, who are sponsoring the vote, justified their decision to proceed by declaring that the ACA will “raise the price of health care, raise the cost of health insurance, reduce access to the American people and continues to get in the way of employers hiring new workers.”

Republicans believe the Democrats are vulnerable on the issue of healthcare reform, but at the same time the Democrats apparently have plans to make the Republican votes a major issue in the 2014 mid-term elections.

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Posted in Denials Management, Medical Receivables, Patient Experience, Patient Financial Services .

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