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Q: After healthcare reform, what should be providers' big concern?

A: Medicare, which can be harmed or helped by the reform issue. Medicare should stand alone as a payment issue. The House is using it as a ‘pay for' issue, taking out the market- basket update, and that's not a good thing. Our goal is to save that market basket, within or outside of health reform.

Q: Even though Medicare is a secondary payer of services?

A: The market basket is the only predictable vehicle of increasing Medicare payments year to year. [Medicare is] not the biggest fish but it's a very important fish.

Q: What are your hopes now?

A: Two things: that the Senate prevails on the market basket issue and that the House prevails on the RUGs refinement, which really changes the payment system to look at complex clinical care, as opposed to just having major rewards on the therapy side.

Q: Won't this reform debate just stretch into 2010 or beyond?

A: I honestly don't think it will last beyond Christmas. It's nearly the end of the year, and next year we'll be talking about elections and a huge other agenda for many people. So in most people's minds, 2009 is a cutoff point.