Happy new year: Bonus predictions for medical practices for 2017

by Richard Scott on Dec 22, 2016
You'll find an array of fearless predictions in the forthcoming pages of Part B News (next issue date: January 2), as our editors and experts alike assay the winds of the medical practice industry to guess what's on tap once the calendar flips to 2017.
But, as one might expect, a single issue can't hold all of the guesswork, the prognostication, the audacity of crystal-ball-looking that could paint us eagle-eyed savants able to read the tea leaves or, should we fall flat, false prophets confusing our green tea with our chamomile.
The early count shows that we acquitted ourselves fairly well during last year's predictions issue -- we nailed five predictions and several others, for which data are pending, appear promising -- so let's go out on a limb and offer some bonus predictions for 2017. As usual, our experts helped guide us down the perilous path of making firm claims, and this year doing so amid an especially turbulent time.
Close your eyes, let your mind wander ahead to a not-too-distant future and imagine:
No major parts of Obamacare will be changed in 2017. It's much too soon to expect major provisions of the Affordable Care Act (ACA) to go asunder over the next calendar year, predict medical practice experts. That's not to say no one expects change to occur -- not in the least. Given campaign promises and known public positions of the president-elect and the health care leaders he has already appointed, significant change is almost a guarantee.
But one year is awfully fast. Consider some of the key pieces of the ACA -- health insurance exchanges, Medicaid expansion, coverage of pre-existing conditions, coverage for children until the age of 26 and, of course, massive delivery system changes. "I don’t think one year is enough time to construct, propose and pass an alternative for any of these pieces," projects Daphne Saneholtz, attorney with Brennan, Manna and Diamond in Columbus, Ohio.
Of course, chances are we'll see some form of repeal next year. But, in the near term, it remains wholly unclear what a repeal might promise. "The new administration has vowed to repeal the ACA but has yet to offer many clues about what replacement would look like," says Michael Strazzella, attorney with Buchanan, Ingersoll & Rooney, Washington, D.C.
Delivery system changes that are working to move the health care system toward value-based care are deeply ingrained across provider and payer networks, and altering them significantly could prove difficult. The most likely transformation may be a rejiggered system for the health insurance exchanges.
"Exchanges are crumbling on their own because the plans sold aren't attractive to younger and healthier patients who aren't getting large subsidies," says Strazzella. "It's likely the exchanges will be deregulated and there be an option to get a subsidy outside a government-run exchange."
We'll put our money on that not happening just yet.
Telehealth will take a major step forward -- backed by policy -- as a viable service option this year. Over the past several years, we've witnessed a trickle of services become eligible for telehealth under the Medicare physician fee schedule. This year, we'll see telehealth enter the (relative) prime time.
"It has momentum and support on the Hill, and industry is clamoring for broader reimbursement options in a number of disciplines," reports Strazella.
A big step forward could come through various means. "We hope legislators will be more aggressive in moving the issue forward, but CMS could do the most good by opening up policies like restrictions on originating sites and adding more broadly applicable codes," suggests Strazzella.
Whether it's through legislation, the fee schedule or another avenue, let's call 2017 the year telehealth came into its own.
Blog Tags: CMS, health care reform, HHS
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