What a Trump election might mean for the ACA

In an article published November 9th on the Health Affairs BlogTimothy Jost, Emeritus Professor at the Washington and Lee University School of Law and a member of the Institute of Medicine, cataloged the potential ramifications of what a Trump Presidency might mean for the Affordable Care Act.  A summary of Jost's arguments are included below:

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GAO recommends priority setting to reduce quality measurement burden

The US Government Accounting Office said in a report that the Department of Health and Human Services (HHS) should comprehensively plan and set timelines in developing more meaningful quality measures, and prioritize development of electronic quality measures.  The Medicare Access and CHIP Reauthorization Act of 2015 called for GAO to examine the use of quality measures across HHS programs and private payers, with a focus on reducing burden. In the report, HHS concurs with the GAO recommendations.

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Raising Medicare eligibility would save in some areas, add in others

Raising Medicare’s eligibility from 65 to 67 in 2014 would save the federal government an estimated $7.6 billion, but would also result in an increasing out-of-pocket health care costs for 65 and 66 year olds by $5.6 billion, and cost employers $4.5 billion in retiree health-care costs, according to a study by the Kaiser Family Foundation.
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Consumer advocates worry that ACO’s may drive up costs

Consumer advocates worry that new mergers involving hospitals, clinics and doctor groups, in attempts to form Accountable Care Organizations (ACO’s), may end up reducing competition, driving up costs and creating incentives for doctors and hospitals to reduce care in order to retain their cost-saving bonuses, according to The New York Times.
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CMS releases final 2010 OPPS rules

CMS on Friday released its final outpatient prospective payment system (OPPS) rule for calendar year (CY) 2010, under which the agency will give providers a 2.1% annual inflation update and pay approximately $32.2 billion in 2010 for outpatient services—a $1.9 billion increase from projected payments in CY 2009. Hospitals that do not meet quality reporting requirements, however, will receive a 0.1% inflation update.

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IPPS rule has fewer new quality measures in FY 2010

Last month, CMS released its final IPPS rule for FY 2010, which makes few changes to the Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU) initiative. The final rule for FY 2010 adds just four new measures, retires one measure, and harmonizes two measures, for a total of 46 measures required for reporting to receive the FY 2011 full market basket update.
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New York State releases data for HAI rates at specific hospitals

The New York State Department of Health released a report last week outlining hospital-acquired infection rates by hospital and by specific region. The report pulls together data submitted to the Centers for Disease Control and Prevention's National Healthcare Safety Network submitted by the 186 hospitals in the state during 2008.

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CMS proposes changes for hospital outpatient departments in 2010

Under a proposed rule issued by the Centers for Medicare & Medicaid Services (CMS), in the Hospital Outpatient Department Quality Reporting Program (HOP QDRP) program hospitals that did not participate in the program or did not successfully report the quality measures will receive an update in CY 2010 equal to the annual payment update factor minus 2.0 percentage points, or 0.1 percent.
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MedPAC releases report on Medicare payment policy on changing incentives to reward value, not volume

Today the Medicare Payment Advisory Commission (MedPAC) releases its June 2009 Report to the Congress: Improving Incentives in the Medicare Program. MedPAC’s report focuses on how incentives in the Medicare payment systems could be changed to strengthen the Medicare program and promote quality care for Medicare beneficiaries.

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