Views

The government wants to tell us how much to pay our doctors

Albany, N.Y., politicians want to take control of changing health care delivery by using their authority to set health insurance premiums, according to a March article in Capital New York. Did you read that right? Yes. You did.

A similar “value-based payment” proposal has been espoused by the Department of Health and Human Services, which recently announced that it intends to shift Medicare reimbursement.

In fact, in an email invitation to stakeholders, the New York State Senate Standing Committee on Health and the Senate Standing Committee on Insurance announced a roundtable discussion at 12:30 p.m. on Monday, April 27, in Albany, “to discuss and examine issues relating to value-based payments. Value-based payments are designed to replace fee-for-service payments and lead to payments based on positive health results.”

Also see: “Does another enrollment deadline extension help or hurt the ACA?”

New York Governor Andrew Cuomo’s administration believes that our fee-for-service reimbursement system encourages excess utilization. The New York State Department of Financial Services, which regulates commercial health insurers, may require payment reform in the commercial insurance space as a part of their annual review and approval of insurer requests for insurance premium rate increases. Value-based payments was included in Governor Cuomo’s budget proposal, but removed by both houses. It now awaits passage.

This underscores the concern all Americans have about escalation of health care expenditures. But, does anyone really want the government in the middle of how we access care?

Also see: “Medicaid expansion is hitting home.”

Hasday is chief operating officer of Frenkel Benefits, LLC, one of the largest privately held independent employee benefits brokers in the United States. Reach him at chasday@frenkel.com or (212) 488-0200, and read more from Hasday at frenkelyspeaking.com.

For reprint and licensing requests for this article, click here.
Healthcare benefits Healthcare plans
MORE FROM EMPLOYEE BENEFIT NEWS