Louisville Medicine Volume 64, Issue 7 | Page 21

Our Holiday Packages Sealed with RED TAPE Tom James, MD I n the holiday season, we expect to find our surroundings festooned in green and red….and at the time we are seeing a changing of the guard in Washington, it is not surprising that the nation’s capital is awash with those same seasonal hues. There is a lot of green in Washington: the color of money. The 2016 budget for the Centers for Medicare and Medicaid Services (CMS) was nearly one trillion dollars*. That would work out to be roughly $300,000 appropriated for every person in the country. Yes, green is a vibrant color in Washington... and CMS contributes only one-third of the health care dollars in the US with the rest coming from businesses, patients and their families, states and write-offs. Under Congressional intent, red ink is not to be used in Medicare mailings. That is why the Sustainable Growth Rate (SGR) formula was buried, in favor of the Medicare Access and CHIP Reauthorization Act (MACRA). Changes in Washington typically come slowly. Large organizations like CMS have such a wide range of programs and mandates that they behave more like the many-headed hydra of mythology than a programmatic monolith. As such, the holiday color of red has come to be represented by red tape. So, boys and girls, we have come to learn that the seasonal colors of green and red are celebrated in Washington not just for the holidays, but all year long. HO, HO, HO. * https://www.cms.gov/About-CMS/Agency-Information/ PerformanceBudget/Downloads/FY2016-CJ-Final.pdf Dr. James is the chief medical officer for Baptist Health Plan and Baptist Health Community Care. DECEMBER 2016 19