MACRA MIPS? Time for GACRA GIPS to hold lawmakers accountable.

How can we hold Congress accountable for the failed policy they continue to foist on American patients and doctors?

Meet GACRA GIPS, the Government Accountability Credibility Realignment Assessment and Government Incentive Payment System.

With GACRA GIPS, if congressmen and congresswomen don’t work, vote, complete their tasks and create a budget that lives within our means well paying down the national debt, they don’t get paid.

Learn more about this needed reform in the latest article by IP4PI founder Craig M. Wax, DO published by Medical Economics:

http://medicaleconomics.modernmedicine.com/medical-economics/news/your-voice-physician-accountability-let-s-legislate-congressional-accountability

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Promoting Choice and Competition to Empower Patients and their Physicians

A friend of IP4PI writes in:

I just read President Trump’s executive order on choice and competition across state lines. It has these amazing provisions which have not been discussed in the media at all!! These provisions go to the heart of a competitive market-based healthcare system.

“(c) My Administration will also continue to focus on promoting competition in healthcare markets and limiting excessive consolidation throughout the healthcare system. To the extent consistent with law, government rules and guidelines affecting the United States healthcare system should:

(i) expand the availability of and access to alternatives to expensive, mandate-laden PPACA insurance, including AHPs, STLDI, and HRAs;

(ii) re-inject competition into healthcare markets by lowering barriers to entry, limiting excessive consolidation, and preventing abuses of market power; and

(iii) improve access to and the quality of information that Americans need to make informed healthcare decisions, including data about healthcare prices and outcomes, while minimizing reporting burdens on affected plans, providers, or payers.”

The whole order can be read here: https://www.whitehouse.gov/the-press-office/2017/10/12/presidential-executive-order-promoting-healthcare-choice-and-competition . I love the title to promote choice and competition.  I don’t think the order was overreach, because the language is to ” PRIORITIZE three areas for improvement in the near term: association health plans (AHPs), short-term, limited-duration insurance (STLDI), and health reimbursement arrangements (HRAs).” and “FOCUS on promoting competition in healthcare markets and limiting excessive consolidation “.  I did note this part:” Public Comment. The Secretaries shall consider and evaluate public comments on any regulations proposed under sections 2 through 4 of this order.”

Stay tuned for opportunities to comment!

Alexander-Murray Exacerbates Flaw in ACA’s “Catastrophic Plans”

DPC physicians and patients take note!

An aspect of Alexander-Murray will exacerbate an under-appreciated flaw in ACA requirements for plans considered “catastrophic plans.”

Alexander-Murray will allow anyone to have a “catastrophic plan” as such plan is defined by ACA. ACA limits enrollment in these plans to enrollees under 30 years of age or enrollees who have a waiver. Alexander-Murray would do away with these limitations. So far so good.

Another ACA limitation on these plans — found in  ACA section 1302(e) — is that the plans will provide no benefits until the enrollee’s annual out of pocket limit has been reached, except that the plan must cover “at least 3 primary care visits.”

This will harmful to patients of DPC practices and is bad policy. It essentially forces primary care to be handled in-network — great for the insurance companies but not for the patients orthe doctors.

Ideally the requirement should be struck from ACA.  Alternately, a small change along the lines of this or something similar [in brackets] might help fix this problem:

(B)the plan provides—
(ii)coverage for at least three primary care visits, [unless the enrollee is separately contracted with a direct primary care physician, in which case the plan will refund to the enrollee an amount equal to the value of such coverage.]