“Democrats aren’t wor­ried about providers be­cause they think that hos­pi­tals and doc­tors are mak­ing out like ban­dits un­der these pro­grams.”

Modern Healthcare - - The Week In Healthcare -

sure Repub­li­cans to avoid the au­to­matic trig­ger, the po­ten­tial for provider cuts pro­vided lit­tle in­cen­tive for Democrats to push for a com­mit­tee agree­ment.

“Democrats aren’t wor­ried about providers be­cause they think that hos­pi­tals and doc­tors are mak­ing out like ban­dits un­der these pro­grams,” said Peter Fer­rara, a se­nior fel­low for en­ti­tle­ment and bud­get pol­icy at the con­ser­va­tive Heart­land In­sti­tute. “They are more likely to go to the trig­ger.”

The pos­si­bil­ity that the com­mit­tee will fail and au­to­matic across-the-board cuts will oc­cur is one of the great­est con­cerns for the Amer­i­can Hos­pi­tal As­so­ci­a­tion, said Richard Pol­lack, ex­ec­u­tive vice pres­i­dent for ad­vo­cacy and pub­lic pol­icy. “We want real re­form, not just provider ratch­et­ing down,” he said. “We’ve al­ready had big cuts through the Affordable Care Act.”

Al­though providers and their rep­re­sen­ta­tives say it is too early to know pre­cisely how they will de­scribe the im­pact of provider cuts on ac­cess to care to the se­lect com­mit­tee mem­bers, Congress and the Amer­i­can pub­lic, many plan to urge al­ter­nate money-sav­ing ap­proaches.

For in­stance, some hos­pi­tal ad­vo­cates sup­ported ac­cel­er­at­ing ini­tia­tives from the 2010 health re­form law that aim to im­prove qual­ity and lower costs.

In ad­di­tion, Val­adka sug­gested in­cor­po­rat­ing some ver­sion of the sub­si­dized in­surance plan for Medi­care pro­posed by Rep. Paul Ryan (RWis.) be­cause it would al­low providers to save the sys­tem money by vary­ing their charges based on what their pa­tients could af­ford.

“That would go a long way to make Medi­care sol­vent,” Val­adka said, “at least on the provider side.” deficit over 10 years, or if the full Congress fails to pass their plan, then the Bud­get Con­trol Act would re­quire $1.2 tril­lion in au­to­matic cuts be­gin­ning in 2013. The law splits those cuts be­tween the De­fense Depart­ment and, gen­er­ally, Medi­care providers and in­sur­ers.

Op­ti­mists hope the prospect of the au­to­matic cuts will pro­vide in­cen­tives for Repub­li­cans and Democrats to ham­mer out a deal. “If the fis­cal com­mit­tee took no ac­tion, the deal would au­to­mat­i­cally add nearly $500 bil­lion in de­fense cuts on top of cuts al­ready made, and, at the same time, it would cut crit­i­cal pro­grams like in­fra­struc­ture or ed­u­ca­tion,” a White House de­scrip­tion said. “That out­come would be un­ac­cept­able to many Repub­li­cans and Democrats alike— cre­at­ing pres­sure for a bi­par­ti­san agree­ment with­out re­quir­ing the threat of a de­fault with un­think­able con­se­quences for our econ­omy.”

But some providers and ad­vo­cates said that al­though the de­fense cuts would work to pres-

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