STAT and WaPo: Will RFK "Blow Up" CMS Payment Systems?

According to new reports in STAT and Washington Post, the Trump administration might want to blow up CMS payment systems.  Per RFK Jr, the proposed Secretary of Health, the payment systems encourage resources spent on chronic illness rather than health and prevention.

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Find the Washington Post here (Dan Diamond).   Find STAT here (Rachel Cohrs Zhang).

See also, my November 20 blog on Trump health nominees & UCSF's Vinay Prasad.  
See also, my November 14 blog on RFJ Jr as health secretary.

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According to the two articles, RFK Jr's team is exploring vigorous reforms to Medicare’s physician payment system to prioritize preventive care and health promotion over the current “sick care” model. Sources conveyed that the incoming leadership views the existing coding framework as rewarding expensive procedures and surgeries, while discouraging primary care and chronic disease prevention. Kennedy and his team view this as a core issue driving poor U.S. health outcomes compared to other countries. 

A range of proposals, not systemically unveiled yet, could reduce the influence of the AMA, which dominates both coding and Part B (RVU) pricing.  The initiative syncs with the new administration's broader “Make America Healthy Again” agenda, which would focus on sources of chronic disease and rebalancing health care priorities to support wellness and prevention.

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The WaPo article quotes Columbia University's Prof. Miriam Laugesen, whose book, "Fixing Medical Prices," is a favorite of mine (Harvard Univ Press).

The new HHS effort may harvest earlier thinking in this space.  See, Center for Public Integrity (2010), "Little-Known AMA Group...".  See Fuchs, SLU Journal of Health Law (2013), Medicare Price Problems.  See Center for American Progress (2018), Rethinking the RUC.  But see AMA (2018), Criticism of RUC Needs Rethinking.   AI CORNER: See these four articles discussed by AI here.