While Medicare held the spotlight for much of the debate over health care reform last year, the changes to the health care program for seniors and the disabled that were most widely acknowledged were the $575 billion in cuts to the program. These cuts threaten to result in reduced benefits or access to health care providers. But this isn’t the only way in which the passage of the Patient Protection and Affordable Care Act will affect seniors. In recent Heritage research, Clete DiGiovanni, MD, and Robert Moffit, Ph.D., lay out some of the other important changes to Medicare which could, depending on the direction taken in pending regulation, challenge the doctor-patient relationship and undercut physician autonomy:
Standardization of Care. The PPACA creates a new Patient-Centered Outcomes Research Institute, which will be charged with setting research priorities and advance studies of comparative effectiveness research. Though there is no problem with advancing evidence-based research to influence medical decision-making, DiGiovanni and Moffit write that, “The key issue, to be resolved through regulation, is the precise relationship between providers’ reimbursement and plan coverage and the findings of comparative effectiveness research.. statutory conditions are not to be construed as “preventing” the Secretary from using such evidence in determining coverage or reimbursement.”
Changing Physician Practice. The new law also creates the Center for Medicare and Medicaid Innovation within the Centers for Medicare and Medicaid Services, which will propose alternatives to Medicare’s current fee-for-service model. DiGiovanni and Moffit write that, “While there is obviously nothing wrong with experimenting with new models of physician payment, it should take place in an economic environment where patients control the flow of dollars in the system. It appears that the law’s replacement of traditional Medicare fee-for-service payment is to be coupled with a form of managed care, meaning that Medicare patients’ choice of physicians and treatment options is limited by those doing the managing.”
The new health care law threatens to disrupt the relationship between doctors and patients by altering payment methods and employing excessive regulation through a heightened role for bureaucracy in Medicare. To read more about the changes seniors face, click here.
This post was co-authored by Derek Pyburn.