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Payment Reform on Track, Medicare Chief Says

By MedPage Today  
   March 23, 2018

The CMS principal deputy administrator tries to reassure House members concerned with proposed budget cuts.

This article first appeared March 22, 2018 on Medpage Today.

By Joyce Frieden

WASHINGTON -- Pay no attention to that funding cut behind the curtain -- physician payment reform and patient empowerment are alive and well, Demetrios Kouzoukas told House members at a hearing on Medicare's physician reimbursement system.

"I think we share the goal of making sure patients have access to care in a way that makes sense for them," Kozoukas, who is Director of Medicare at the Centers for Medicare & Medicaid Services (CMS), said Wednesday at a House Ways and Means Health Subcommittee hearing on the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA). "As we embark on this journey, we will do it in a way that makes sense for each community."

But committee Democrats did not seem convinced. "I'm more than a little troubled looking at contrasting what you're talking about here in encouraging tones, but [then there is] the budget from the administration that's a third-of-a-trillion-dollar cut, and their efforts to undermine attempts to pay for value over volume," such as making some Medicare programs in this area voluntary rather than mandatory, said Rep. Earl Blumenauer (D-Ore.). "I think we all ought to be troubled by this schizophrenia on the part of the administration."

Variety of Issues Raised

Rep. Terri Sewell (D-Ala.) was also concerned. "The president's proposal to cut Medicare ... would send shock waves throughout the healthcare system," she said. "A disproportionate amount of folks in my district live in remote rural areas; I can't tell you how many hospitals closings I have attended ... We have to make sure we look for creative ways to have access."

"So often, many of my constituents can't make primary care appointments because of the long distance, and they don't have anyone to help them get there," she said. "I know we'd save lots and lots of money if we could figure out a way to help people make [it to their] appointments."

Kouzoukas tried to reassure her. "We are working to make sure the programs we undertake and the way we implement them won't [harm] rural providers," he said of the possible cuts.

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