At Risk

“The people who are delivering care are increasingly at financial risk for the services that are being rendered,” Dan Mendelson, CEO of Avalere Health, a Washington consulting firm, said in a phone interview. “It’s increasingly likely the physician or the hospital is going to make more money if they provide less care.”

The country’s main lobbying groups for doctors and hospitals said they were on board, at least with the broad idea behind the overhaul. “We support secretary Burwell’s goals and plans,” said Maureen Swick, a representative of the American Hospital Association.

Robert Wah, president of the American Medical Association, said that physicians were worried about additional bureaucracy. “This idea that we’re talking about delivery reform and setting up a system of delivery reform, we’re very supportive of that,” Wah said in an interview in Washington. “The details will be important to see.”

Industry Reaction

Burwell met with about two dozen health industry officials this morning to brief them on the administration’s plan. Participants included executives of Verizon Communications Inc., Boeing Co., UnitedHealth Group Inc., Anthem Inc. and representatives of large hospital chains and physician organizations.

The Affordable Care Act, often criticized by its opponents for not doing much to control health-care costs, created several programs the Obama administration now plans to rely upon to end fee-for-service payments. For example, the law penalizes hospitals with high rates of readmissions of Medicare patients within 30 days of discharging them, and encourages doctors and hospitals to band together and closely coordinate their care, with the aim of reducing redundancies and inefficiency.

Those programs have saved about 50,000 lives and reduced health-care spending by about $12 billion, based on preliminary estimates, the health department said.

 

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