Welcome to Practice Rounds, our weekly column exploring what's being covered in the larger world of healthcare.
The day after Donald Trump was elected president, more than 100,000 people signed up for health coverage under the Affordable Care Act. This many people signing up for coverage (the busiest day for 2017 enrollment since Nov. 1, when it began) symbolizes the challenge that Trump and his team, as well as the Republican-led Congress, will face in fully repealing the law. According to health policy experts, fully repealing the law would lead to 20 million people losing health insurance. Many of these people, the Los Angeles Times reports, rely on Medicaid, which has been expanded through the law. Others use commercial plans and receive government subsidies to help pay for high premiums.
Will Trump's Presidency mean value-based care is about to take a big hit? It's entirely possible, according to Health Data Management. The publication says that Republicans have expressed concern over demonstration projects for "untested value-based care approaches." They are concerned that value-based care does not protect providers from financial penalties, Health Data Management reports. If anything, the pace of change from volume to value could slow down, say experts. Other health policy followers, however, such as Eric Cragun, of the Advisory Board, say there is bipartisan support for value-based care and it will continue under a Trump presidency.
Three doctors — Aaron Stupple, an internal medicine physician in Boston; Andrew Goldstein, a primary-care physician in New York City; and Stephen Martin, a primary-care physician in Barre, Mass. — wrote to President-elect Trump this week in Stat and asked him "to do no harm." They also suggested that he "improve primary care," saying that primary care is essential to helping the "forgotten Americans" that Trump talked about in his post-election speech. They also asked him to invest in public health, provide affordable health insurance, negotiate drug prices, protect our veterans, and aim for quality care. "We all need compassionate and informed leadership that listens to patient needs and to those who have committed their lives to this calling," they wrote to Trump.
Quote of the Week:
"There is finally a glimmer of hope that the crushing burden that government has placed on medicine may be lifted under a new president. I am still stunned at the results but grateful we have a proven business owner elected to take the helm of a broken country. Get the bureaucrats off our backs and out of medicine."
Christopher Claydon, MD, a Scottsboro, Ala.-based internist