Photographer: Kholood Eid/Bloomberg

Trump Health Nominee Embraces Obamacare Programs the Last Guy Ended

President Donald Trump’s nominee to oversee Medicare says he’s a fan of paying doctors and hospitals in new, potentially more efficient ways through experimental payment programs set up under Obamacare.

The federal agency he’s been picked and that administers the programs to run just killed off three of them.

Alex Azar

Photographer: Eric Thayer/Bloomberg

“One of the great legacies of Secretary Burwell’s tenure was launching so many of the alternative payment models that we have out there,” Alex Azar, Trump’s nominee to lead the Department of Health and Human Services, said Wednesday in Washington. “I’d like to keep driving that forward.”

Sylvia Mathews Burwell ran the department under President Barack Obama, and was responsible for implementing and running some of the Affordable Care Act programs that changed how Medicare pays for services. Medicare covers more than 50 million elderly and disabled Americans, and its payment policies have wide influence.

Obamacare mandated what are known as bundled payments for some episodes of care, such as heart attacks or hip fractures. Medicare typically pays for individual procedures, which critics say drives up costs by giving doctors or hospitals incentives to provide more services. Bundling creates a single payment for an entire course of treatment, giving doctors an incentive to be more efficient.

Read more: Trump Slows Efforts to Cut Health-Care Costs

On Thursday, the Centers for Medicare and Medicaid Services -- a sub-agency of the health department -- said it will shift to voluntary participation for the hip and cardiac programs, and shrink a third program for other joint replacements while also making it voluntary in many parts of the country.

“Focusing on developing different bundled payment models and engaging more providers is the best way to drive health system change while minimizing burden and maintaining access to care,” Seema Verma, the administrator for the Centers for Medicare and Medicaid Services, said in a statement Thursday. “We anticipate announcing new voluntary payment bundles soon.” Verma will report to Azar if he’s confirmed.

Spokesmen for HHS and CMS didn’t respond to requests for comment.

The cancellations signaled a philosophical shift from the Obama administration, which sought to use a combination of incentives and mandatory changes to transform how medical care is paid for and delivered. Under Trump, the agency has become more reluctant to push doctors into payment arrangements that could lower their reimbursements.

Rolling back the payment programs was initiated under Azar’s predecessor, Tom Price, who resigned in September over his extensive use of private aircraft.

— With assistance by John Tozzi

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