Dr. Ashok Rai, president and CEO of Prevea Health, believes the way health care providers are paid needs to change from the current fee-for-service method to one based on the quality of care offered and the ability to keep patients healthy.
This past summer, Rai, who serves as board chair of the American Medical Group Association (AMGA), had the opportunity to share those views with members of Congress when testifying before the Energy and Commerce Committee on the Medicare Access and CHIP Reauthorization Act of 2015 and merit-based incentive payment system. He was one of five doctors asked to testify before the panel, which oversees Medicare Part B.
“As calm as I appeared, I was definitely nervous, but the members of Congress were respectful and engaged in asking questions,” Rai says. “It was definitely one of the biggest honors of my career. I am the first generation of my family born in the United States and to have my parents and kids see me testifying was important.”
Rai told Congress that while providers like Green Bay-based Prevea have spent millions of dollars changing the way they operate to provide more patient-focused care and wellness initiatives, some health systems have not made the change, which makes the playing field uneven.
“The CMS (Centers for Medicare and Medicaid Services) is not implementing the law as it is written, and they need to be doing that,” Rai says. “We made progress getting the law into place, but the administration makes exclusions and provides off-ramps to delay and water down the rules.”
Rai discussed with panel members how Prevea’s incentive payment system based on quality works and how it was implemented.
“Sharing our solid quality numbers and the operational changes we made was important and being able to articulate Prevea’s story and our perspective here from Green Bay was even better,” says Rai, who will become AMGA’s outgoing chairman at the end of this year. “I still hear from committee members who have follow-up questions or want more information. Sharing our story was important.”