March 15, 2015

Two Ways The Federal Government Is Lagging Behind In A Post-ACA World

In her latest piece for Morning Consult, District Policy Group President Ilisa Halpern Paul asserts that while the Affordable Care Act was enacted nearly five years ago, the federal government continues to operate in a pre-ACA mindset – much to the detriment of patients/consumers and health professionals.

There have been an increasing number of health and hospital systems integrating, joining forces and otherwise partnering to create economies of scale, which are bumping up against the Federal Trade Commission’s (FTC) long-standing presumption that an increase in market share will create harm for consumers in the form of increased prices for in patient hospital care and services. In the column, Ilisa quotes Drinker Biddle Partner, Rob McCann who states, “if providers combine in the pursuit of accountable care, it is illogical to presume their primary motivation is to raise prices, as a mature pay-for-value market is more like a zero-sum game.”

In addition to FTC regulations and mind-set being behind the times, Ilisa explicates an archaic Medicare payment rule that does not allow reimbursement for advanced practice nurses who certify seniors who need home health care.

To view the Morning Consult article in full, please click here.

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