Why Tom Price as HHS Chief Could Be Good for Doctors

Leigh Page


December 02, 2016

In This Article

Finally, Rescue From Medicare?

When Medscape reported on the nomination of Tom Price, MD, for Secretary of Health and Human Services (HHS), on November 28, an internist commenting on the story wrote, "FINALLY."

Many doctors have high expectations that Dr Price will rescue them from the burdens of Medicare reporting programs, the swift transition to value-based payments, and doctors' growing inability to make a living.

In fact, Dr Price is probably in the best position to make these changes and may eventually succeed, says Joe Antos, PhD, a health policy expert at the American Enterprise Institute, a conservative think tank in Washington, DC. But he adds that making such changes would be very challenging and could well take years to accomplish.

As HHS secretary, Dr Price is positioned to take "a more active role" in the Centers for Medicare & Medicaid Services (CMS), which reports to HHS and is responsible for many of the policies that concern doctors, Antos says.

"Previous HHS secretaries often didn't have the experience to interpret the complexities of CMS policies and regulations," Antos says. "Price is a clear exception."

Dr Price knows how to get things accomplished in Washington. A six-term congressman from Georgia, he is chair of the House budget committee and a leading healthcare policymaker in the Republican Party.

And he works well with others. Even though he has been leading the charge to repeal the Affordable Care Act (ACA) and holds to all of the Republican orthodoxies, Dr Price is regarded as a skilled negotiator.

Patrice A. Harris, MD, chair of the American Medical Association (AMA), is a psychiatrist from Dr Price's home state of Georgia and has known Dr Price for 15 years. "Dr Price has always been willing to listen and to hear both sides of an informed debate," she told Medscape.

A Strong Supporter of Doctors' Interests

The AMA recently sent out a release[1] saying that it "strongly supports" Dr Price's nomination.

"Dr Price has had a relationship with the AMA for decades," Dr Harris reports. Specifically, the release said that Dr Price's policies "reduce excessive regulatory burdens that diminish time devoted to patient care and increase costs."

Having practiced as an orthopedic surgeon for two decades, Dr Price intimately understands the problems of running a practice, and he has been a strong defender of doctors' concerns with the Obama administration's healthcare policy.

For example, he has been following every step of the rule-making process for the Medicare Access and CHIP Reauthorization Act (MACRA), the federal law that moves Medicare from fee-for-service to value-based payments and consolidates physicians' reporting programs.

When the MACRA final rule was released in October, Dr Price made a statement: "We are deeply concerned about how this rule could affect the patient-doctor relationship, and I look forward to carefully reviewing it."[2]

In a release[3] supporting his appointment, the American Academy of Orthopaedic Surgeons (AAOS) said that Dr Price has "worked closely" with the AAOS on issues such as oversight of mandatory bundled payment models, increasing flexibility within electronic health record programs, and protecting the patient-physician relationship.

To an unusual degree, even for a doctor-politician, Dr Price puts doctors' interests high on his political agenda. This can be seen in the Empowering Patients First Act, the bill he has been introducing as an alternative to the ACA in each session of the House since 2009. Tim Jost, JD, emeritus professor at the Washington and Lee University School of Law and leading scholar on healthcare policy, was recently quoted as calling the bill the "empowering doctors" act.[4]

Dr Price's bill[5]would enact not one, but three, different kinds of federal tort reform. First, it would impose a 3-year window for filing malpractice lawsuits. Second, it would set a $250,000 cap on noneconomic damages. And third, it would create "administrative healthcare tribunals" to review lawsuits before they go to court.

The bill would also remove restrictions that have prevented physicians from raising their charges. First, the act would allow physicians to "balance-bill" Medicare beneficiaries—to charge them more than Medicare's allowable charge—which is currently illegal. "Medicare limiting charges do not apply to Medicare charges by the eligible professional," the bill reads.

Second, the bill would allow physicians to join together and negotiate with insurers without violating federal antitrust laws. According to the bill, it "exempts healthcare professionals engaged in negotiations with a health plan regarding the terms of any contract under which the professionals provide healthcare items or services from the federal antitrust laws."


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