Although the plan from House budget committee chair Paul Ryan (R-Wis.) paints in broad strokes, it represents a clear political salvo in a November election that will decide the White House and majorities in both legislative houses.
Where those changes could leave the healthcare industry is uncertain, says Cindy Moran, assistant executive director for government relations at the American College of Radiology. Yet she does think changes are on the horizon in the next year—or sooner.
“We’re in a transformative time in the history of healthcare,” Moran says. “We can’t run away from the reality that the Medicare has to be fundamentally restructured for some semblance of it to survive in the years going forward. The private sector is evolving very quickly to a streamlined, more efficient, better-outcome delivery system.”
Moran says that although it’s impossible to anticipate the specific impact of such legislative efforts on the imaging field, “what’s been going on for the last five to seven years is unsustainable.
“Policymakers have just squeezed money out of the providers, and you can only squeeze so much money out of them,” she says. “I think it’s inevitable that the benefits package is going to be restructured.”
Moran points out that budget resolutions are always thematic in their tack, but that “the real dirty work” takes place in the authorizing committees.
“If you take out some of the more inflammatory rhetoric [of Ryan’s budget],” she says, “at some point, cool heads will have to talk about what needs to happen in the Medicare program to keep it sustainable.
“I don’t think that’s going to happen in this environment,” Moran says, “but the discussion needs to start this year.”
Whatever form specific compromises may take, Moran says, hospitals and radiologists in specific cannot continue to absorb indefinitely smaller reimbursement rates. She is hopeful that any new direction would redistribute some of the responsibility for cost-control measures.
“I would like to get the bead off our back,” she says. “The only bills that have been passed are taking money out of physicians and out of hospitals. I would like somebody to take a step back and start looking at some of the bigger, broader public policy decisions that can be made.”