Volume 11
Whether you’re an investor, physician, healthcare executive, it’s impossible to keep up with all the research, policy, information – and misinformation! – that will impact patients and our industry. This newsletter provides actionable intelligence to help payers, investors, practitioners, and thought leaders to solve the big problems in healthcare.
This week we take a look at the 2022 election results and how they could impact policymaking; cover how the seasonal flu and RSV cases are straining hospitals and emergency rooms; discuss how to address clinician burnout; and take a look at the industry’s latest financial results and what they mean.
#1: Takeaways from Election Night
Big Synopsis: Going into Election Day, most analysts predicted a Republican “Red Tsunami” with huge gains in the House and the Senate. After last night’s results, however, that wave looks a bit more like a trickle. Republicans will likely win back the majority in the House, but not by too much. As for the Senate, control remains a toss up with races in Arizona, Nevada, and Georgia still outstanding. It’s quite possible control of the Senate could be determined after December 6 when it appears Democrat Sen. Raphael Warnock will have a run-off with Republican Hershel Walker.
So What’s The Big Deal: Historically, the President’s party loses big in the first midterm election. And last night, that just didn’t happen. So why? While some point to reproductive rights over economics (inflation) as the main issue that drove young voters and women to the polls, many miss how those issues are inextricably linked. When people are struggling or worried about economics, having control over family planning is as much of an economic issue as personal freedom.
So What’s Next: Count the ballots.
#2: What's Planned for Healthcare in the Lame Duck Session?
Big Synopsis: The election is over, but the 117th Congress is not. Federal lawmakers will reconvene on November 14 for a “lame duck” session. In addition to tackling spending legislation for fiscal year 2023, they will consider important healthcare legislation.
So What’s The Big Deal: In healthcare, all eyes will be on how (or if) Congress will address planned Centers for Medicare and Medicaid Services’ (CMS) physician rate cuts. (See #3). But that’s not all Congress could consider. Lawmakers may extend some of the public health emergency flexibilities implemented at the beginning of the COVID pandemic. Given continued workforce shortages, the Senate also may take up a bill passed by the House on workplace violence. Each issue would have a huge impact on healthcare.
So What’s Next: We will need to see what Congress will or won’t do during the lame duck session. Many insiders believe there will be some fixes (albeit temporary) to CMS physician rate cuts, but to what degree? What Congress decides to do could make a huge impact on the balance sheet for healthcare services for 2023 and 2024.
#3: Will Congress Prevent Deep CMS Rate Cuts to Physicians?
Big Synopsis: As noted above, one issue docs are hoping Congress will address during the lame duck session is CMS’ plans for physician fee reimbursement. Last week, the agency finalized cuts in its physician fee schedule. Almost immediately, clinician groups turned up the volume on lawmakers, asking them to reverse the cuts as part of the end-of-the-year spending package that must be passed by Dec. 16.
So What’s The Big Deal: To some, a 4.5% reimbursement haircut may not seem that significant but that’s only a piece of the story. CMS’s reimbursement cuts paired with other planned CMS cuts in 2023 paired with declines in private payer reimbursements could have a significant negative financial and psychological impact on providers. Those are not the only financial headwinds, however. Inflation, supply chain challenges, burnout, and now further pay cuts from Medicare are complicating the balance sheet for physicians and physician practices.
So What’s Next: See #2. The lame duck session is the last hope for preventing the cuts from taking place. If Congress is unable to come up with a package that is acceptable to a majority of lawmakers, physicians will face these cuts amid continued financial headwinds for providers.
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