By Michael W. Cropp
What happens in Washington following the recent collapse of the Senate’s efforts to repeal and/or replace the Affordable Care Act (ACA) is uncertain. What is certain is the fact all Americans should expect – and deserve – access to high-quality, affordable health care.
The Senate’s inability to reach consensus on an ACA replacement bill clearly demonstrates the complexities and intricacies of health care in this country, and underscores the fact that sustainable solutions to transform our nation’s health care system cannot be easily or quickly achieved.
Perhaps members of Congress will now be more inclined to reach across the aisle to develop sustainable solutions to ensure adequate coverage and access to quality care for everyone.
Whatever form new efforts to repeal, replace or improve the ACA take, it is our hope the following foundational components are included:
• Preventive coverage. Getting preventive screenings and building a trusted relationship with a primary care doctor is the foundation for improving and maintaining good health, so we would like this to be a key part of any new legislation.
• Market stabilization. There should be recognition that the health insurance industry requires certain tools to ensure long-term stability and affordability of health care coverage for all, such as through risk adjustment and reinsurance.
• Prescription drugs. We have to address the increasing costs of prescription drugs if we want a sustainable and affordable health care system that works for patients, employers and governments.
We don’t have to wait for, or rely on, Washington to fix health care. As I have stated repeatedly and continue to firmly believe, legislation alone will not solve all of the challenges facing our health care system. Recognizing and supporting the need to address underlying costs is a critical component of sustainable reform and must begin with the rapid transition from a fee-for-service payment model for providers to a model that rewards positive experience and results (value-based payment).
Value-based care rewards physicians for providing patients with evidence-based medicine, while advancing safe, appropriate and effective care as opposed to a volume-based, fee-for-service model that rewards more – and often unneeded, duplicative and, in some instances, potentially harmful – tests, treatments and procedures.
A number of forward-thinking physician practices here in Western New York are on the leading edge of moving to these alternative payment models.
To keep moving forward, we need to transform our region into a high-quality, high-performing health care community by investing in the growth and revitalization of primary care, leading the transformation to a value-based payment model and collaborating with other key community partners to provide the education, support and tools businesses and individuals need to lead healthier lives.
Michael W. Cropp, M.D., is president and CEO of Independent Health and a board-certified family physician.