Weekend update

Congress is out of town. Healthcare Dive reports that a Senate hearing held last week, CMS Acting Director Andy Slavitt floated the popular idea of delaying the January 1, 2017 start date for the new MACRA system for compensating doctors under Medicare Part B.  The nub of the problem is that

As things stand, the final rules for MACRA [enacted in 2015] are slated to be published November 1, with implementation on January 1, 2017, giving providers just two months to learn and implement the rules.

CMS's failure to address the problem could drive more doctors out of Medicare Part B.

Robert Pear from the New York Times brought us up to date on government oversight of health insurance premiums in the ACA marketplaces.   (OPM currently is reviewing FEHB plan benefit and rate proposals for 2017.)

Pear's article reminds us that the ACA converted health insurers into public utilities which also are subject to heavy government oversight. Meanwhile, Modern Healthcare reports that doctor compensation generally is rising above the rate of inflation, which as health insurers have pointed out is a cause of rising health insurance premiums along with prescription drug costs, etc.

Travis Singleton, senior vice president at recruiter Merritt Hawkins, has been in the business 17 years and the year-over-year pay increases in the firm's survey this year were the largest he's seen. “It's clearly showing a healthcare system at capacity,” Singleton said. “We're now in year three of this sort of employment dominated model.”

Volume still rules in reimbursement to provider organizations, despite a movement toward value-based payment schemes by the government and private payers, Singleton said. Consolidation of physician practices into larger groups and groups joining hospital systems have helped push up physician pay as well, Singleton said.