AHA Eyes 'Extremely Challenging' 2014

John Commins, for HealthLeaders Media , January 24, 2014

"And also, for opportunities, it is probably the one piece of legislation in the healthcare field that will pass this year, whether it is a permanent extension or something less than that. So it is also the place where we need to talk about issues such as the 96-hour rule, the two midnight policy, the RACs, the Medicare extenders for rural programs, etc. That is what we are going to be looking at the next couple of months as we know that Congress will be too."

See Also: SGR is Finally on its Way Out. Maybe.

Nickels says the chances are better than ever this year for permanent repeal of the SGR because Congressional Budget Office estimates have significantly reduced the projected cost to between $140 billion and $180 billion. "The issue though, becomes how do you come up with that kind of money? Because that is still a pretty heavy lift as it relates to coming up with savings."

"There are a variety of places and lists and it seems like once policies get on these lists they never go off. "We worry about that," he says, "because a number of those policies would be very harmful to us, such as looking at cuts to hospitals that provide evaluation and management services in outpatient departments, cuts to graduate medical education, or rural hospitals, etc. All of those have been on the list and that is very disconcerting. In order to do justice to getting an SGR permanent fix Congress really needs to look elsewhere to try to find savings."

Nickels suggests Congress should look instead at Medicare structural reforms that could include means testing, combining Medigap reform and combining Medicare Parts A and B. "In order for this to come to fruition, Congress needs to come up with these kinds of reforms to the program, which would not only do the program good, but could come up with that level of savings," he says.

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