Reimbursement News

Fixing Medicare, Medicaid a Top Priority for New Coalition

AMA, AHIP, Blue Cross Blue Shield Association, and other industry groups are partnering to fix healthcare, including Medicare, Medicaid, and private coverage.

Medicare and Medicaid

Source: Thinkstock

By Jacqueline LaPointe

- Healthcare industry heavy-hitters are partnering to form a new coalition that generally aims to “improve what’s working in health care and fix what’s not,” especially in Medicare, Medicaid, and other government programs, according to a recent press release.

The American Medical Association (AMA), Blue Cross Blue Shield Association (BCBSA), Federation of American Hospitals, America’s Health Insurance Plan (AHIP), and PhRMA are creating the Partnership for America’s Health Care Future (PAHCF).

Other organizations part of the coalition’s launch include the Association for Accessible Medicines, American College of Radiology, Council of Insurance Agents and Broker, and Healthcare Leadership Council.

“This coalition brings together a broad and diverse group of American health care leaders who are on the front lines of care delivery. Together, we believe that there is more that can be done to strengthen our current health care system, advocate for commonsense solutions, and fix what is broken,” Erik Smith, PAHCF’s spokesperson, said in the press release.

“The Partnership for America’s Health Care Future will work to find ways to improve the parts of our health care system that work, including Medicare, Medicaid, and other government programs, and it will identify how, together, we can expand health care access and options, foster continued innovation and improve affordability.”

The website states that the mission of the partnership is “support building on the strength of employer-provided health coverage and preserving Medicare, Medicaid, and other programs that so many Americans depend on, so we can deliver affordability, expand options, improve access, and foster innovation.”

PAHCF plans to address the following issues with the current healthcare landscape:

  • Affordability: addressing the cost drivers behind chronic disease and poor health and fostering better individual and community health
  • Options: engaging patients and consumers to choose the care and coverage that best fits them and their families
  • Access: improving employer-sponsored health coverage, as well as Medicare, Medicaid, and other programs, to ensure all individuals can access affordable coverage and high-quality care
  • Quality: ensuring the most highly trained and accessible provider workforce
  • Innovation: fostering new tools, treatments, and technology that will improve patient care

The PAHCF also emphasizes on its website that it will focus on preserving the Medicare program for seniors. The group’s launch comes just days after the Medicare and Social Security Trustees predicted the Medicare Hospital Insurance Trust Fund to run dry by 2026, three years earlier than expected.

The insolvency of the fund could create access issues as hospitals incur greater uncompensated care costs and receive Medicare reimbursement that may not cover costs.

PAHCF Erik Smith also told RevCycleIntelligence.com that the coalition will also tackle stabilizing the individual marketplace.

The nine industry groups formed the new group to bring attention to these issues, Smith added in an email.

“We believe that the current health care system must be improved to help patients achieve affordable and accessible health care that fits their health needs,” he explained. “We formed this partnership in order to add our voices to the conversation regarding policy fixes that will deliver affordability, expand options, improve access and foster innovation.”

How the coalition plans to address Medicare, Medicaid, and other top priorities is still up in the air as the nine founding organizations reach out to other stakeholders.

“Right now, the group is still in its early stages,” Smith said. “We’re focused on adding new members to the Partnership and identifying policy solutions designed to increase affordability, expand options, improve access and foster innovation.”

The nine industry groups currently spearheading the project stem from diverse backgrounds, oftentimes leading to conflicting opinions on health policy and changes. But the new partnership promises to bring diverse voices together to advance high-quality, affordable care.