Daniel Cane, President and CEO, Modernizing Medicine
Last week: News that I find compelling is that Affordable Care Act premiums are expected to increase by an average of 25 percent. This is significant for a number of reasons, including how this will affect the number of uninsured in the country, how the possible cost increase will affect those that are insured, how insurers will react and what the political ramifications might be.
Looking ahead: The Centers for Medicare & Medicaid Services (CMS) passed a final rule massively revamping how doctors will be paid. Historically, healthcare used a “fee for service” model creating potentially perverse incentives for how, and how much, care was provided. Recently, there has been a movement towards “pay for performance” manifesting itself in the new CMS rules that compensate for quality, not quantity. Healthcare providers nationally will be scored on a variety of measures, and their overall “Physician Compare” results will be publicly available. The combination of changing healthcare reimbursement models and transparency represents a tectonic shift in the country’s largest industry.