One of the things that you see when you read Project 2025 is not just the racist dog whistles, but some ideas that were exactly lifted from some of the most extreme white supremacists ever.
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Department of Health and Human Services
The Risk Adjustment Data Validation C(RADV) rule;
The Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration; and
The Global and Professional Direct Contracting (GPDC, rebranded as the Accountable Care Organization Realizing Equity, Access, and Community Health or ACO REACH) model.
Additionally, regulations should advance site neutrality by eliminating the inpa
tient-only list and expanding the ambulatory surgical center covered procedures
list. Medicare generally pays more for inpatient hospital procedures and less for
the same procedures performed in an outpatient setting. Whether a medical ser
vice is delivered in a physician’s office, a clinic, or a hospital setting, the Medicare
payment for that service should be the same. CMS should expand the application
of site-neutral payment options to more settings. Such a policy would level the
playing field among providers and remove the financial disabilities for medical
professionals who would compete with hospital systems.”*
Finally, HHS needs to restore and enhance conscience protection regulations
that allow medical practitioners to participate in federal health care programs
without being compelled to provide sex changes or similar services.
LEGISLATIVE PROPOSALS
Remove restrictions on physician-owned hospitals. The Affordable Care Act (ACA)* imposed restrictions prohibiting Medicare from reimbursing physician-owned and specialty hospitals. The current restrictions do little more than serve the special interests of large hospital systems and undercut consumer choice of high-quality, specialty care. These restrictions should be removed so that physician-owned hospitals can compete with other hospitals in serving Medicare patients.”°
Encourage more direct competition between Medicare Advantage and private plans. Medicare Advantage (MA), a system of competing private health plans, is the major alternative to traditional Medicare for America’s large and growing cohort of seniors. The program provides beneficiaries with a wide range of competitive health plan choices—a richer set of benefits than traditional Medicare provides and at a reasonable cost. Equally as important, the MA program has been registering consistently high marks for superior performance in delivering high-quality care. Critical reforms are still needed to strengthen and improve the program for the future. Specifically: