By RaeAnn Grossman
In case you missed it. Donald Trump was elected the 45th President of the United States on Tuesday, November 8th along with 34 U.S. senators, 238 members of the U.S. House of Representatives, 12 governors, 10 attorneys general, 5 insurance commissioners and 6,900 state legislators. Following Tuesday’s election, Republicans will control the Legislative and Executive Branches of the federal government, as well as more governorships than any time since before World War II. The last time one political party controlled both branches of the federal government was from 2009 – 2010 when Democrats used their majorities to pass major legislative initiatives including the ACA and Dodd-Frank Financial Services Reform.
Health care was a focal point during the closing days of the campaign. Election exit poll data indicated that 45% of voters believed the ACA went too far while 31% said it did not go far enough.
Everyone is a flutter about the election. But let’s think of this as it impacts today, 2017 and 2018, and let’s add in what Trump has said since the election.
Changes today: Nothing changes for your 2016 strategies for Commercial, Medicaid or Medicare Advantage.
Suggestions for today: Better track impacts by line of business including benefit plan, (individual medal, small group, etc.), disease or chronic condition, and provider participation. Watch CMS press releases not the media.
Changes for 2017: Here you need to continue your 2016 dates of service review for 2017 transfer payments. Continue your 2015-2016 dates of service medical record review for CMS Medicare Advantage sweeps dates. Continue Medicaid risk adjustment tactics until further notice.
Thoughts for 2017: Trump shared that he will be leaving the pre-existing and extended coverage of children in the regulation, but as this adds costs we need to watch where those funding dollars will come from. There could be a change in reimbursement or change in premium development elements (such as a weighting system).
Thoughts for 2018: Stay tuned in to your legal affairs updates. Find flexible, innovative vendor/partners, keep updated on IT to ensure there are no data control issues, and monitor your dashboard to see what strategies impact what products, population, and provider practice patterns. Value-based should enhance risk adjustment, but let’s watch the numbers.
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