Letters: Proposed Stark law reforms could bring unintended consequences

Reforms that support the expansion and adoption of value-based care should move us forward. While the changes highlighted in the article “Doctors and hospitals support value-based Stark law changes” are designed to do just that, the proposed regulatory reforms have potential unintended consequences that could hinder rather than help our healthcare system.

Creating considerable uncertainty, many of the proposed reforms fail to use the “bright line” test that we have been assured is the goal of Stark law regulations. There are also significant differences between the changes proposed by the Office of Inspector General and the CMS. The proposed changes will create additional administrative burden and increased costs that physicians must take into account. This is especially a concern for smaller physician groups or providers serving rural communities. I believe the CMS should consider creating a separate exception for rural providers with fewer requirements, as they often have a more difficult time transitioning to value-based care.

As a large national medical group committed to value-based care, my organization must have certainty that we are not running afoul of Stark law while entering into risk-based arrangements. Actions that are absolutely necessary to protect against waste and abuse should be the agency’s primary focus, and again, a provider’s time and financial commitment must be considered.

Finally, we understand the notion of limiting potential rewards to “non-monetary compensation,” however thoughtful alignment of incentives must be achieved, including financial, if these reforms are truly going to propel the industry toward coordinated and more affordable care.

Shawn Morris
CEO
Privia Health

The recent article “Hospital mergers don’t improve readmissions, mortality or experience, study finds” stated, “Harvard researchers found that hospitals acquired by health systems experienced a modest decline in patient experience scores while performance on 30-day readmissions and mortality rates stayed largely flat.”

The scam has always been to allude to some popular issues to justify hospital mergers. The big three are integrated care, improved quality and value. The sole reason, however, has always been to preserve or gain market power. What do hospital administrators know about healthcare quality? For too many of them, the answer is nothing.

In their obsession with dominating provider care, administrators have successfully marginalized the medical community, notably physicians and nurses. Employing physicians and rendering the organized medical staff impotent has basically taken the group that can actually improve medical quality and value out of the equation.

There will be no improvement in healthcare quality until the yoke is removed from the medical profession and power is shared appropriately.

Dr. Allan Dobzyniak
Eastport, Mich.