Trump Officials, After Rejecting Obama Medicare Model, Adopt One Like It

WASHINGTON — In a notable back flip, the Trump administration has decided that maybe the Obama administration was right in its efforts to change the way doctors and hospitals are paid under Medicare.

The Trump administration said late Tuesday that it was starting a Medicare payment model very similar to the ones it canceled and curtailed last year. The Obama administration devised the earlier projects using authority in the Affordable Care Act.

In the new program, as described by Trump appointees, Medicare will make a single “bundled payment” for nearly all the services provided in a 90-day period to certain Medicare patients who are admitted to a hospital or have certain outpatient medical procedures.

Health care providers can receive a bonus if they hold Medicare spending for these patients below a target set by the government, and they may have to repay the government if Medicare spending for them exceeds the target.


Tom Price, the first secretary of health and human services under President Trump, accused the Obama administration of trying to “commandeer clinical decision making” by forcing doctors to participate in experiments that test new ways of paying for care. Participation in the new project is voluntary.

Medicare has traditionally paid a separate fee for each service. Seema Verma, the administrator of the federal Centers for Medicare and Medicaid Services, said the new bundled payments were “an important step in the move away from fee-for-service and toward paying for value.”

– New York Times