This seems like it should be good news for physicians…
Physicians will get a 0.5% pay increase each year for 5 years under a deal by a bipartisan team of House and Senate negotiators to repeal the sustainable growth rate (SGR) formula for physician payment under Medicare.The part that caught my eye was
The bill provides a 5% bonus to physicians who receive at least 25% of their Medicare revenue from an alternative payment model in 2018. Alternative payment models include accountable care organizations, patient-centered medical homes, and others. The 25% threshold increases over time, according to the summary.I looked up "alternative payment models" under the ACA, and found this.
Risk-based arrangements (i.e., budget-based contracting) payments are predicated on an estimate of what the expected costs to treat a particular condition or patient population should be. This includes capitation, bundled payments, and shared savings arrangements….The onus is on the physician to be able to manage expected utilization and related practice expenses for treatment. Success is based on the practice’s ability to control the health care expenses of the patient population so that they do not exceed the budgeted amount.That seems a bit similar to the budget limits proposed under single payer.
Global operating budgets for hospitals, nursing homes, allowed group and staff model HMOs and other providers with separate allocation of capital funds.I'm not sure if my perception of a similarity between these two proposals is correct. From the original article:
The proposed system entails an unprecedented degree of healthcare micromanagement by the federal government, according to David Howard, PhD, health policy professor at Emory University in Atlanta.I wouldn't call single-payer micromanagement of healthcare by the government. Of course the ACA is not anywhere near single-payer, but maybe the 5% bonus can get doctors to gradually get used to moving in that direction.