The impact of Donald Trump’s election on the healthcare landscape is beginning to take shape.  Along with his election, the Republican Party has retained control of both houses of Congress and a large majority of state legislatures and governorships. 

The most significant news is the nomination of US Rep. Tom Price and Seema Verma as the Department of Health and Human Services (HHS) secretary and administrator of the Centers for Medicare and Medicaid Services (CMS), respectively.  Rep. Price is a physician and an avowed opponent of the Affordable Care Act– more commonly known as Obamacare–since its inception, having introduced several bills to repeal or revise Obamacare since 2009.  As Chairman of the House Budget Committee, he is well versed in the give-and-take of the legislative process.  Seema Verma is a healthcare consultant who was instrumental in creating the Healthy Indiana Plan, Indiana’s Medicaid expansion program under Vice President-elect Mike Pence when he was Governor of Indiana.  This plan combines high-deductible insurance plans with healthcare savings accounts to insure Indiana’s Medicaid and low-income populations.  

What does this mean for transitional care and chronic care management programs?  We do not anticipate dramatic changes.  

• Rep Price is considered “provider friendly” so it is unlikely that HHS or CMS will remove or reduce reimbursement for these services, as they are currently budget-neutral and promote quality.
• The transition to value-based reimbursement across all service lines may slow to ensure a more thoughtful analysis of this economic model. Individual states may be given more control over Medicaid programs if funding moves to a block-grant model, as previously proposed by Republican lawmakers.
• Reductions in regulations may create more opportunities for providers to innovatively outsource services that lower costs and maintain quality.

We also feel that any changes will come slowly.  The prospect of millions losing coverage during Obamacare reform is politically untenable, especially in states that carried Trump in 2016.  The process of creating healthcare legislation is frequently compared to the complex and messy process of making sausage.  Hopefully the results of future reform will prove to be more palatable to providers.