(Transcript by Riverside AI)

Dana (00:00) Hi, we're back everybody for episode three, four, that was fast, of the Future Proof PT podcast. And Alex and I are gonna talk about a couple of topics today. We thought first cover what's happening on the Hill. Things are moving fast and slow in Congress. I thought I'd just give sort of an overview of what that means and what therapists should care about

what could or couldn't happen in Congress in the next few weeks through few months. And then we thought we'd cover the categories of alternative payment models. And Alex did a really awesome job breaking down the different types of models from a musculoskeletal care perspective.

And then maybe we can have a dialogue about how each of those sort of fits into the healthcare industry's perspective on alternative payment models. Does that sound good?

Alex (00:52) sounds terrific and I think luckily we will be able to package it in 55 minutes or less for our dear audience to be able to consume it and regurgitate it by Monday. looking forward to hearing your explanation and also looking forward to learning as we go as well.

Dana (01:07) Awesome. Okay, so there's a lot being thrown around right now, budget resolutions and budget reconciliations and continuing resolutions and debt ceilings and government shutdowns. So just to give an idea of what these terms mean, super high level, as of today or a couple of days ago, the House passed what they call a budget resolution. And

that budget resolution says each of the committees of jurisdiction in the House of Representatives has agreed to a dollar amount that they have to cut from what they're responsible for. So Energy and Commerce Committee has to cut X amount. I think it's 880 billion.

then the week before that the Senate did the same thing except they decided that they're just going to do a small bill.

they said don't want to take on everything. We don't want to take on taxes. So instead, we're just going to take on defense and energy and the border. So the Senate passed this smaller budget resolution,

Now the Senate and the House have two different budget resolutions and They have to now come together and decide what is going to be the final dollar amount.

So there's a lot that still has to happen and nobody has made any decisions yet about where that money is going to come from.

Alex (02:26) yeah, like, so it sounds like there's a remainder of contingencies that have to be resolved for this process to be finalized. And the constraints of this process is the actual polarization on a higher level and lack of desire to come to a common ground, right? what do you think are these contingencies that are easy

to resolve from your stem.

Dana (02:48) What the Senate has decided on is the easy components to resolve, right? So one option is the House decides to break down into two bills, but you know, President Trump told the House he wants one big beautiful bill. So he wants everything covered in one budget reconciliation bill. He doesn't want to do two.

But this year, two are allowed. So the Senate's decided we want to do a smaller bill, pass that, pass a budget reconciliation, and then taxes, maybe when we're tackling the debt ceiling. Right, so if the House and the Senate now have to decide what's next, the challenge is that what the House has come up with is going to require really big cuts.

the president is saying we're not going to touch Medicare, we're not going to touch Medicaid, we're not going to touch Social Security. It's difficult to find money in those categories when we're not touching it. So it's going to be interesting to see where they come up with the money that they can cut. So that's really the big hang up is we want to pass the Trump tax cuts. That's their goal, the administration's goal. But it's hard if we can't figure out where the money is going to come from.

So then we can jump to the debt ceiling. So somewhere in the summer we have to raise the debt ceiling because So they could raise the debt ceiling and just borrow more and pass more spending and pass the tax cuts that way by increasing the amount that we're allowed to borrow.

Then in the meantime, we also have to deal with the continuing resolution, We passed this three month continuing resolution. And so why that's meaningful for therapists is the telehealth extender. So allowing telehealth by physical therapists and other therapists and allowing the expansion of telehealth in fee for service to be able to allow someone to be in their home and receive telehealth.

That is completely dependent on congressional action and congressional funding, and it expires March 31st. The rest of the continuing resolution, except for a few healthcare things, expires March 14th. So if the two houses of Congress and both parties can't agree, then the government will shut down.