“You can't simply deal with Medicare by cutting doctor payments forever,” Moffit said. “It will be like Soviet free speech: It's there, but it doesn't mean anything.”
At the Federation of American Hospitals annual meeting in Washington last week, Wyden said this year is the time to tackle the issue. “I think everybody understands that there will not be major healthcare reform on the floor of the Congress in 2012,” he said. That creates an opportunity for “an adult conversation,” he said, because unless lawmakers make fundamental changes to the program they must make incremental cuts “that will hurt seniors, will hurt healthcare providers, and that will essentially continue until the Medicare guarantee—and I use this word specifically—has been vaporized.”
Not surprisingly, that conversation will bring with it a host of questions, says Anna Howard, the Medicare reimbursement and health policy director at the law firm Drinker, Biddle and Reath. Those include whether beneficiaries would still have traditional Medicare as an option, and, if traditional fee-for-service is viable only for beneficiaries until a certain date, what would happen to the risk pool after that date. And those are just a few questions pertaining to beneficiaries.
“From the provider perspective, the question then becomes: How are payments going to be handled?” Howard said. “To the extent that fee-for-service continues, would the fee schedules and payment rates stay the same? Would they change? And really, what's the marketplace going to look like?”
Richard Pollack, executive vice president at the American Hospital Association, said the topic is on the agenda at the organization's nine regional policy board meetings that began last week and will continue through March.
“I think, by and large, people view it as something that deserves consideration,” Pollack said from one of those meetings in Atlanta last week. “Then you get down to the details.”