Speaking at a conference of the American Federation of Hospitals this week, newly installed U.S. Secretary of Health and Human Services (HHS) Alex Azar laid out his priorities for healthcare reform including, “using experimental models in Medicare and Medicaid to drive value and quality throughout the entire system and removing government burdens that impede this value-based transformation.” In addition, he highlighted the need to give consumers greater control over health information through health information technology and encourage price transparency from providers and payers. During the speech, Secretary Azar acknowledged that the results to date related to accountable care organizations (ACOs) have been “underwhelming,” but that the continued reliance on fee-for-service is not sustainable, therefore, HHS will concentrate on developing alternative payment models that focus on outcomes rather than volume. Secretary Azar’s comments represent a major shift from the earlier priorities laid out by former Secretary Tom Price, MD, which focused on voluntary models and reducing physician burden.
In response, ASCRS and the Alliance of Specialty Medicine will be communicating our perspective to Secretary Azar and his team, reminding them that there are very few specialty focused APMs—none that are ophthalmic-focused at all—and existing models, such as ACOs, are primary care-focused and often do not allow specialists to participate. We will continue to advocate to maintain a viable fee-for-service system for specialists who provide episodic care, such as ophthalmologists, and do not coordinate care with other practitioners. We will keep you updated.