HHS Presses on with Regulatory Reforms
The five points suggest that the Trump administration will have a new regulatory approach to fostering the shift from fee-for-service care models to value-based models, Matthews says.
"One of the things [the Obama administration tried] to do is put in guidelines that you have to comply with to show you are doing better care rather than more care, and you get more money if you are doing what the government says you ought to be doing, and less money if you don't."
"That creates a real problem for the medical system because most doctors feel they are providing very good care—the best care that they can provide—without the government telling them they have to do this as opposed to that," he says.
While the Trump administration and GOP members of Congress are unlikely to abandon value-based care models, Price will likely end mandatory participation in new value-based payment programs, says Michael Adelberg, principal at the Minneapolis-based law firm Faegre Baker Daniels.
"In general, Republicans like value-based models and most are happy to see them move forward; but the Secretary's previous comments suggest he doesn't like when providers are forced into these models," Adelberg says.
'Experimenting in Medicaid'
Until President Trump and the GOP-controlled Congress pass new healthcare legislation, Republican zeal to curb costs in the Medicaid program will be channeled through HHS and CMS.
"They will try to give the states a great deal more flexibility in seeking and receiving waivers to federal rules," says Adelberg, who served in leadership roles at CMS for 15 years, working in the Medicare, Medicaid, and PPACA Marketplace programs. The last title he held at CMS was director of insurance programs/acting director of exchange policy and operations.