The Good and Bad of Healthcare Reform

The great healthcare reform bill has passed—great as in size, and not necessarily in content, given the continued threats of massive reimbursement cuts. Although many provisions in the bill were important changes the ACR supported, we were unable to fully support the overall bill because it is missing the crucial fix to appropriately reimburse physicians without jeopardizing healthcare access for Medicare patients.

That said, in this month’s column I will recap the key provisions of the new healthcare reform bill and how they will affect you and your patients. While healthcare reform missed the mark on Medicare and physician reimbursement, there are some provisions in the new law that will help our patients.

Some Positive News for Rheumatologists

The ACR has been going to Capitol Hill to educate members of Congress on a variety of issues. Two of these issues—improved reimbursement for dual-energy X-ray absorptiometry (DXA) and the authorization of a pediatric loan repayment program—became law as part of the healthcare reform bill. One provision will restore payments for DXA services furnished during 2010 and 2011 to 70% of the 2006 Medicare rate. The rates will be retroactive to January 1, 2010. The Secretary of Health and Human Services is authorized to request a study on the ramifications of Medicare payment reductions from the previous year and to submit the study to Congress.

The pediatric loan repayment program authorizes the establishment of a loan repayment program for pediatric subspecialists who agree to work in medically underserved areas. This provision was a part of the Arthritis Prevention Control and Cure Act (H.R. 1210/S.984) that the ACR and the Arthritis Foundation lobbied Congress to pass. Physicians, health professionals, and patients should be proud of their hard work. These two provisions were included in the bill because of our work through Advocates for Arthritis, the ACR’s annual Capitol Hill fly-in, and thousands of visits, telephone calls, and e-mails over the past few years.

Quality

Quality continues to be the buzzword in healthcare, and several provisions related to improving quality were included in the legislation. The law creates a national strategy for quality improvement to better health outcomes, efficiency, and the patient-centeredness of healthcare for all populations.

President Barack Obama took a vital first step in implementing the strategy by nominating Donald Berwick, MD, MPP, to become the new administrator for the Centers for Medicare and Medicaid Services (CMS). Dr. Berwick is the current president of the Institute for Healthcare Improvement, which works to accelerate healthcare advances by cultivating promising concepts to improve patient care.