IRVINE, CA--(Marketwired - Dec 15, 2016) - "While repeal of the Affordable Care Act has been defined as a top priority of the Trump administration, total replacement of the ACA is unlikely," predicted Dr. Tom Giannulli, Chief Medical Officer for Kareo, the leading provider of clinical and business management software for independent medical practices. "Strong opposition by key democratic senators makes direct path to repeal and replacement difficult, so medical practices should instead prepare for a set of modifications to the existing law that may be the path of least resistance and the best option for both parties."
Many of these could be based upon the 37-page proposal of Paul Ryan for modification of the ACA.
Looking at early policy commitments and recent announcements as they relate to healthcare, a path seems to be materializing, although not highly specific, that offers some directional guidance on what might happen. Giannulli sees the following changes happening:
- Reduction of Medicaid expansion
- Expansion of the use and flexibility of high deductible plans (HDPs), health savings accounts (HSAs), and purchasing insurance across state lines, a trend already underway
- Increase of consumerized healthcare and pricing transparency
- The ability to purchase drugs from other developed countries at reduced prices
Giannulli continued, "At this point, there are few signs that the shift to value-based care will be significantly impeded by the Trump presidency or Congress. Despite the ACA being the sentinel legislation for value-based care, follow-on legislation such as the bipartisan MACRA law cemented the path to value-based reimbursement for all Medicare providers over the next five years. This is driven in large part by the pending insolvency of Medicare by 2025, and the need to slowly but consistently mitigate this risk by moving towards alternative reimbursement models."
Therefore, Giannulli predicts:
- The gradual shift away from fee-for-service should still be anticipated over the next 12 to 24 months as the MACRA Quality Payment Program is put in place and begins to effect practice revenues beginning in 2019
- Increasing need to drive better patient outcomes, as practice revenues will be a function of reported quality scores
- The increasing mismatch between high deductible plans and the need to improve patient outcomes will lead to more innovative incentives for patient compliance
Giannulli concluded, "While this analysis is based on early information, there are clear directional signals as to how practices should be preparing for the next 12 months. The most notable is that there is no indication that MACRA will be changing or going away, and that success with value-based programs may become more challenging in the years to come. So, while we watch to see what will happen with the ACA, physicians and practices should continue to prepare for participation in MACRA."
Kareo is the only cloud-based complete medical technology platform purpose-built to meet the unique needs of independent practices. Today Kareo helps over 35,000 providers in all 50 states run more efficient and profitable practices, while delivering outstanding patient care. The Kareo technology platform is the first to help independent practices find more patients, manage their care with a fully certified and easy-to-use EHR, and get paid quickly all in one complete and integrated package. Kareo has received extensive industry recognition, including the Deloitte Technology Fast 500, Inc. 5000 and Black Book's #1 Integrated EHR, Practice Management and Medical Billing vendor. Kareo's growth further demonstrates the expansion and vitality of the independent practice market in the U.S. With offices across the country, Kareo's mission is to help independent practices succeed in an ever-changing healthcare market. More information can be found at www.kareo.com.