Payment, quality results still top focus for AHCA following 'shock' of election

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The American Health Care Association will maintain its focus on preserving reimbursement streams for providers in the wake of election results that “nobody fully anticipated,” an executive said Tuesday.

In a call with reporters, Clifton J. Porter II, senior vice president for government affairs with AHCA, said the group had somewhat of a “game plan” in place based around an expected divided government.

“Obviously November the 8th was a shock to all of us, everyone in Washington was more or less planning for a different outcome,” Porter said. “The actual realization of a President-elect Trump … but also a Republican Senate was something that I think nobody fully anticipated.”

AHCA plans to stay focused on improving quality in member facilities and preserving adequate reimbursement, Porter said. Bundled payment or Center for Medicare & Medicaid Innovation programs may be slowed or eliminated under a new administration, he added.

CMMI has recently received harsh criticism from lawmakers who believe it spends too much on programs that don't demonstrate tangible savings. Despite that, the agency may be kept as a “laboratory for concepts that have been near and dear to Republican thinkers,” Porter noted.

“If CMMI remains and we end up with voluntary programs, I think that would be a huge success,” Porter said.

Providers hoping the final rule and its requirements of participation will disappear have a glimmer of hope under the new administration through a provision of the Congressional Review Act. However, Porter said the reversal process would require 10 hours of floor time that would be “tough to get.” Providers also must now be following Phase 1 of the rule, which went into effect Nov. 28.

AHCA is pleased with the election's outcome with regards to its fight against arbitration, since Republican lawmakers are supportive of the group's position, as well as the potential for a Department of Labor that is “much more business friendly,” Porter said.