New HHS Secretary Dr. Price promises physician-friendly reforms

Based on a partnership with Urology Times, articles from the American Association of Clinical Urologists (AACU) provide updates on legislative processes and issues affecting urologists. We welcome your comments and suggestions. Contact the AACU government affairs office at 847-517-1050 or info@aacuweb.org for more information.

Tom Price, MD, has become the third physician to serve as secretary of Department of Health and Human Services since the establishment of the agency more than 60 years ago.¹

Organizations representing physicians overwhelmingly supported Dr. Price's nomination, although a vocal minority opposed his appointment on varied grounds, including poorly timed health care stock trades and his membership in a politically conservative non-profit group called the Association of American Physicians and Surgeons.

As HHS secretary, Dr. Price will administer a budget of more than $1 trillion and oversee agencies including the Centers for Medicare & Medicaid Services, the National Institutes of Health, the Centers for Disease Control and Prevention, and the Food and Drug Administration. As such, according to Kaiser Health News, he "can interpret laws in different ways… and rewrite regulations and guidance, which is how many important policies are actually carried out."

Dr. Price is also expected to play a key role in repealing the Affordable Care Act (ACA) and making significant changes to Medicare.

Last May, as a member of the House of Representatives, Dr. Price introduced a bill to replace the ACA with tax credits, health savings account incentives, tort reforms, and other health system changes. The goal of the legislation, according to Dr. Price, was to "get Washington out of the way while protecting and strengthening the doctor-patient relationship."

^1.The Department of Health, Education and Welfare was created in 1953 and restructured as the Department of Health and Human Services in 1979. The two previous secretaries with a medical degree are Otis R. Bowen, MD (1985 to 1989) and Louis Sullivan, MD (1989 to 1993).

Next: Dr. Price's voting record

Throughout his time in Congress, Dr. Price has supported traditional and innovative changes to the medical liability ecosystem, from caps to courts. Dr. Price consistently backs federal proposals modeled on successful state reforms that provide fair compensation to patients and limit frivolous lawsuits and awards for noneconomic damages. Additionally, he voted in favor of a bill that protects physicians when they follow "best practice" guidelines, as well as the potential misapplication of quality measures.

Dr. Price also promotes the provision of grants to states to establish specialized courts that have judges dedicated full time to resolving health care disputes. According to Philip Howard, a noted commentator on the effects of law and bureaucracy on human behavior and society, so-called health courts "hold the key to eliminating the staggering waste of defensive medicine better than any other proposed reform."

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While the nature of changes to the Medicare program remain uncertain, there's little doubt that Dr. Price, if confirmed as HHS secretary, will promote decentralization and continue down the path of value-based reimbursement. First and foremost, Republican leaders hope to transition the Medicare program from bestowing defined benefits to a premium support model. Although Dr. Price voted for the Medicare Access and CHIP Reauthorization Act (MACRA), he recently criticized reporting requirements that are especially burdensome to independent physicians. He has also called for an end to mandatory bundled payment demonstration projects, such as the one changing how Medicare pays for joint replacements, which, according to Dr. Price, irresponsibly tie doctors' hands.

Through UROPAC and frequent conference appearances, Dr. Price has long been connected to urologists. He has considerable experience in Congress and the exam room. At this critical time facing physicians and the health care sector, Dr. Price will, according to a spokesman for the Trump transition team, "work to restore the patient-doctor relationship and clamp down on government overreach."