Let's face it, changes are coming. Healthcare is about to undergo another big shift once the new administration comes in. Between the sure things and the big questions, CareOptimize has found a bit of clarity. Join us to learn what our experts advise you to do to stay on top of it all.

2. How Will This Man Impact Healthcare?
The ACA MACRA
MIPS Value Based
Medicine

3. Healthcare in the Time of Trump
What we know.
What we think we know.
What we know we think.

4. Healthcare in the Time of Trump
The Affordable Care Act
- Trump’s Words
- Trump’s Actions
- Surrounding
Circumstances
MACRA/MIPS
- How will it be
Affected?
Value Based Medicine
- Are we still on Track?
- Next Steps

5. What We Know
Along with a lot of uncertainty, there are some things
we do know:
• The Surrounding Circumstances
• Trump’s Words
• Trump’s Actions

6. We Know:
Healthcare is Important
Healthcare
Survey* says:
* According to Reuters/Ipso
1,800 people surveyed; (healthcare 21%, 16% jobs, 14% immigration)

7. We Know:
Trump has a 7 Pt. Plan
1. Repeal/replace Obamacare
2. Allow health insurance to be purchased across
state lines
3. Individuals can deduct insurance premium
payments from taxes (just like businesses)
4. Tax-free Health Savings Accounts
5. Price transparency from practices, providers, and
hospitals
6. Medicaid should be handled on a state level
(not federal)
7. Allow U.S. citizens to purchase drugs overseas from
overseas providers

8. “I do not think [Obamacare is] constitutional.”
“We have to repeal it and replace it with something
less expensive.”
“Obamacare can’t be reformed, salvaged, or fixed. It’s
that bad.”
We Know:
Trump’s Pushing to Make ACA Changes

9. Seema Vera (CMS)
• HIP 2.0 (Healthy Indiana Plan)
Participants make a monthly
contribution or receive a
lockout
• Medicaid expansion
We Know:
What Trump Has Done
Tom Price (HHS)
• One of few with a detailed
replacement plan
Tax credits, Health Savings
Accounts, employer limits,
high-risk pools
• 4 times introduced own legislation
to replace ACA
• Chief Sponsor of the only bill to
reach White House
Appointees

10. The House has ALREADY voted in excess of
times to repeal all or parts of the Affordable Care Act!
We Know:
Surrounding Circumstances

11. Pre-existing conditions
Trump says: “Yes. that happens to be one of the
strongest assets.”
Children on parents’ plan until age 26
Trump says: “We’re going to very much try to keep that.”
Total number of insured
Trump says:
“I’m going to take care of everybody. I don’t care
if it costs me votes or not.”
“Everybody’s got to be covered; this is an
unRepublican thing for me to say.”
We Know:
Micro-perspective

12. MACRA/MIPS
• MACRA is separate legislation from the ACA
• MACRA may be tweaked, but the core should remain
• “Pick Your Path ...Now
1. Don’t Participate = - 4%
2. Submit Something = 0
3. Submit Partial Year = $
4. Submit Full Year = $$$
• Put your process in place to track the 4 Categories

13. Value Based Reimbursement:
Value based reimbursement has received
widespread bipartisan support
New program will focus on
• Patient needs
• Patient satisfaction
• Minimizing costs
• Rewarding providers who innovate and execute

14. Prepare for Value Based Medicine
Invest in a Population Health Management tool to
• Normalize patient data from multiple sources
• Identify high costs and patient groups
• Automate patient outreach
Focus on maximizing bonus payment opportunities
• MIPS
• Increased Risk Contracts with Payers
• Shared Savings Programs
What You Need To Do

15. MIPS Readiness Assessment
The MIPS assessment is a
report card that looks into a
customer’s database and
assesses whether or not they
have the correct setup to be
ready for MIPS.

16. State of the Practice Review
• Detail of Accounts
Receivable
• Payers and Self-pays by
Volume
• Existing and Potential
Denials
• Automation and
Tasking
• Patient Scheduling
• Clinical Workflow

17. CareOptimize Analytics

18. www.careoptimize.com