Healthcare reform is a hot topic at this years’ Medical Group Management Association Annual Conference in New Orleans. Everyone is playing the waiting game, but much speculation has been heard during educational sessions.
A handful of presenters are targeting the SGR rate problem that Congress has yet to fix.
“If reform is based upon the current SGR rate, it’ll be standing on a house of sand with no foundation – no chance of survival,” said Patrick F. Smith Jr., senior vice president of government affairs for the MGMA and a session presenter.
Mention of the SGR rate also echoed at a Monday morning panel discussion led by MGMA President and CEO Bill Jessee. Congress is not expected to fix the rates until the lame duck session later in the year.
During 2010, healthcare providers have seen many decisions and regulations, mainly involving payment reform. Pre-existing conditions, lifetime limits and child-dependent coverage have been taken care of. Small business tax credit and imaging regulations have been handled as well.
Anders M. Gilberg, MGA, vice presiden of public and private economic affairs for the MGMA and a presenter at AC10, said 2011 should yield some standards for electronic transaction, primary care and other incentives, as well structuring of the Center for Medicare Innovation and PQRI measures.
He said there are three payment models to watch:
- Accountable care organizations
- Bundling of payments
- Value-based payment modifiers
Attendees are waiting for answers, too. One asked at the end of a session, “When payments are bundled, who gets the money? “We don’t know yet,” said Smith.
Many sessions focused on general reform objectives – how to control spending, improve access, create incentives and enhance quality.
An eight-state pediatric ACO pilot with Medicaid is expected after the initial ACO rule is released, according to Gilberg, but that has yet to be determined.
Gilberg also suggested that medical practices prepare and test for the transition to HIPAA 5010 and ICD-10.