How Will This Man Impact Healthcare?

The ACA MACRA

MIPS Value Based Medicine

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Healthcare in the Time of Trump

What we know.

What we think we know.

What we know we think.

Healthcare in the Time of Trump

The Affordable Care Act- Trump’s Words

- Trump’s Actions - Surrounding

Circumstances

MACRA/MIPS

- How will it be

Affected?

Value Based Medicine- Are we still on

Track?- Next Steps

What We Know

Along with a lot of uncertainty, there are some things we do know:

• The Surrounding Circumstances • Trump’s Words• Trump’s Actions

We Know:Healthcare is Important

Healthcare

Survey* says:

* According to Reuters/Ipso 1,800 people surveyed; (healthcare 21%, 16% jobs, 14% immigration)

We Know:Trump has a 7 Pt. Plan

1. Repeal/replace Obamacare2. Allow health insurance to be purchased across

state lines3. Individuals can deduct insurance premium

payments from taxes (just like businesses)4. Tax-free Health Savings Accounts5. Price transparency from practices, providers, and

hospitals6. Medicaid should be handled on a state level

(not federal) 7. Allow U.S. citizens to purchase drugs overseas from

overseas providers

“I do not think [Obamacare is] constitutional.”

“We have to repeal it and replace it with something less expensive.”

“Obamacare can’t be reformed, salvaged, or fixed. It’s that bad.”

We Know:Trump’s Pushing to Make ACA Changes

Seema Vera (CMS) • HIP 2.0 (Healthy Indiana Plan)

Participants make a monthly contribution or receive a lockout• Medicaid expansion

We Know:What Trump Has Done

Tom Price (HHS) • One of few with a detailed replacement plan Tax credits, Health Savings Accounts, employer limits, high-risk pools • 4 times introduced own legislation to replace ACA • Chief Sponsor of the only bill to reach White House

Appointees

The House has ALREADY voted in excess of

50 times to repeal all or parts of the Affordable Care Act!

We Know:Surrounding Circumstances

Pre-existing conditionsTrump says: “Yes. that happens to be one of the strongest assets.”

Children on parents’ plan until age 26Trump says: “We’re going to very much try to keep

that.”

Total number of insuredTrump says:

“I’m going to take care of everybody. I don’t care if it costs me votes or not.” “Everybody’s got to be covered; this is an unRepublican thing for me to say.”

We Know:Micro-perspective

MACRA/MIPS

• MACRA is separate legislation from the ACA

• MACRA may be tweaked, but the core should remain

• “Pick Your Path ...Now1. Don’t Participate = - 4%2. Submit Something = 03. Submit Partial Year = $4. Submit Full Year = $$$

• Put your process in place to track the 4 Categories

Value Based Reimbursement:

Value based reimbursement has received widespread bipartisan support

New program will focus on• Patient needs• Patient satisfaction• Minimizing costs• Rewarding providers who innovate and execute

3

Prepare for Value Based Medicine

Invest in a Population Health Management tool to• Normalize patient data from multiple sources• Identify high costs and patient groups• Automate patient outreach

Focus on maximizing bonus payment opportunities• MIPS• Increased Risk Contracts with Payers• Shared Savings Programs

What You Need To Do

MIPS Readiness Assessment

The MIPS assessment is a report card that looks into a customer’s database and assesses whether or not they have the correct setup to be ready for MIPS.

State of the Practice Review

• Detail of Accounts Receivable

• Payers and Self-pays by Volume

• Existing and Potential Denials

• Automation and Tasking

• Patient Scheduling • Clinical Workflow

CareOptimize Analytics

www.careoptimize.com