Last month the national Medical Group Management Conference was held in Denver. There were more then 35 members of the press. This included five from Modern Healthcare which has normally sent one reporter. We were there every day and something new came out, from the insurance industry’s cost report on healthcare reform to the Baucus bill passing committee. It seems like almost every member of Congress wants to have some say in reform that speaks to their own agenda.

 

The national Medical Group Management Association issued policy positions on eliminating consultation services, imaging cuts (both in the physician fee schedule) and legislative proposals, physician owned hospitals, medical liability reform, EHR incentive funds, and repealing and adjusting the sustainable growth rate. The MGMA has taken position on these and other issues regarding healthcare reform. (You can contact me for a copy of the position the MGMA has taken).

 

William F. Jessee, MD, FACMPE, president of the Medical Group Management Association is well respected and has testified on Capitol Hill a number of times. In Dr. Jessee’s address to the attendees at the national meeting he said, “Predicting the future is risky. When you are right, no one remembers and when you are wrong, no one forgets.” He offered five predictions about the outcome of the health reform battles.

 

Finding a way to expand access to health services for 47 million or so Americans is an important objective of reform. Most Americans will have access to some form of basic coverage but some will still fall between the cracks.

 

Hospitals have already agreed to accept a reduction of $155 million in Medicare payments. Home healthcare services, nursing homes, imaging centers, ambulatory surgery centers and inevitably physicians will also be called on to accept lower payment.

 

Exactly which taxes and by how much is unclear. But payment reductions will not cover the full cost of reform. Accordingly, expect some increase in income taxes, taxes on employer-provided health benefits, Medicare payroll taxes, taxes on sugared soft drinks or some combination of these.

 

Current law already provides a “carrot and stick” approach to encourage healthcare providers to adopt electronic records and e-prescribing.

 

Payment reform is moving toward the transfer of risk for rising healthcare costs from payers to providers. Whether through bundled payments, global reimbursement, capitation or some other mechanism the money will increasingly flow to organizations that are large enough to accept and manage the financial uncertainty. Physicians will, in some cases, lead these efforts through consolidation or multispecialty groups. In other cases, hospitals will take the lead.

 

We should all agree that there will be change and we can be proactive or be a victim. And as always, most people do not like change, but there will be change whether you like it or not.

 

Although there is much to learn regarding what shape reform will take, I will take the position that Sir Winston Churchill spoke, “For myself I am an optimist-it does not seem to be much use being anything else.”