2024 Health Policy Updates: Medicaid, Medicare, Telehealth, and Administrative Reforms

Anders Gilberg, Senior Vice President of Government Affairs at the Medical Group Management Association (MGMA), provides an analysis of crucial health care policy updates impacting medical groups in the United States. He discusses recent legislative developments, such as the proposed "One Big Beautiful Bill Act," which targets significant healthcare provisions affecting Medicaid and Medicare payments. The conversation highlights anticipated Medicaid funding cuts, their deferred implementation until 2027-2028, and the complexities surrounding administrative execution.

Medicare payment adjustments are also reviewed, noting a temporary reimbursement increase but emphasizing an unresolved 2025 payment cut requiring a sustainable resolution. Gilberg addresses ongoing administrative burdens in medical practices, including challenges with eligibility verification and concerns about the expiration of Affordable Care Act (ACA) subsidies that could influence patient affordability and insurance enrollment.

Additional discussion focuses on Congress's legislative productivity, particularly regarding administrative simplification efforts and reforms in prior authorization procedures for Medicare Advantage plans. These reforms aim to better align administrative processes with provider needs and patient care efficiency. Changes to the Medicare Physician Fee Schedule are analyzed, highlighting shifts in payment methodologies affecting specialty versus primary care providers, with potential financial impacts on various medical specialties.

Technological initiatives also feature prominently, including the role of artificial intelligence in healthcare, efforts towards electronic health record (EHR) interoperability, and voluntary pledges for IT standardization. These efforts are positioned as key to enhancing data integration and clinical decision-making. The episode also previews upcoming policy deadlines affecting telehealth regulations and rural payment parity, emphasizing their implications for access to care.

Finally, the MGMA Leadership Conference is previewed as an opportunity for stakeholders to engage on these policy issues, share insights, and discuss strategies to navigate the evolving healthcare environment. Practical advice for boosting staff morale in medical practices is also covered, underscoring the human element in managing healthcare operations.