Editor's Desk: Some of this reform stuff will be tough to swallow

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James M. Berklan, Editor
James M. Berklan, Editor

As a nation of mouse clickers, skimmers and channel flippers, there is not much we don't think we can't understand within a few moments. This, of course, is a fallacy, but it frames much of our thinking.

But the fact is, some things are incomprehensible in their entirety. That is my initial thought as I write on the day President Obama signed historic healthcare reform into law.

At more than 2,500 pages, the bill has so many facets and side issues, it's safe to say not even one of the politicians who had to vote on it has read it all. Further complicating the digestion process is that certain provisions of the massive new law become active at different times over the next decade or so.

So what to do? Proceed the same way one would eat the proverbial elephant: one bite at a time.
My eye fixes on a few of the lesser-known provisions:

The Nursing Home Transparency and Improvement Act is one born a few years ago, after a New York Times study alleged that investor-owned operations had been cutting registered nursing hours to pump up profits. Initially, major providers expressed outrage at the bill's demands for ownership details, business partner disclosures and more government oversight.

After meeting repeatedly with Washington lawmakers, leaders of national chains now say they have softened the blow of many, if not all, of the bill's provisions.

There still could be about a year's worth of procedural hurdles to clear before implementation. But one way or another, it looks like the act, and its many remaining hassles, is here to stay.

Another reform item that could soon get more providers biting their fingernails is the creation of a new Medicare Commission, which would set Medicare payment rates. This would not be some easily ignored Medicare Payment Advisory Commission. The new commission is slated to make payment determinations itself, taking cues from the White House while stripping much of the decision-making power from Congress.

Congress, for all its flaws, has ignored MedPAC's zero market basket update recommendations lately—much to providers' relief.

So while some will be craning to see what becomes of high-profile insurance proposals, keep in mind there are plenty of other ideas to chew on. And some of them aren't going to taste too good.
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