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Policy changes to expect in 2020

John Nicolaou, healthcare expert at PA Consulting, discusses price transparency and US healthcare policy changes to expect in 2020.

Read the Managed Healthcare Executive article here

With an election year just about upon us, there are a number of changes coming from the current administration that are going to impact the managed care industry in 2020. Changes in allowable benefits, home health, hospice carve-ins, and new CPT codes for remote home monitoring are just a sample of these.

There are an additional set of fundamental changes coming from the administration affecting clinicians related to payment models. For example, earlier this year, CMS announced five new primary care payment models designed to incentivize the entire healthcare system to transition to value-based care, especially for patients with complex, chronic, and high-need conditions. Here are policy changes that could make a huge impact in 2020.

John says the price transparency regulation proposal, started by executive order earlier in the year, and now part of a CMS proposed rulemaking, is currently in comment period. “This would require hospitals to publish gross and negotiated rates for services in an accessible format, including commonly used ‘bundles’ of services.”

Our new value-based care research shows why putting patients at the centre of healthcare is important and how to do it

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