Biden Administration Offers Bonuses to Doctors Who Implement ‘Anti-Racism Plans’

The Biden administration will offer bonuses to doctors who “create and implement an anti-racism plan” under new rules from the Department of Health and Human Services, a move meant to update Medicare payments to “reflect changes in medical practice.”

Effective Jan. 1, Medicare doctors can boost their reimbursement rates by conducting “a clinic-wide review” of their practice’s “commitment to anti-racism.” The plan should cover “value statements” and “clinical practice guidelines,” according to HHS, and define race as “a political and social construct, not a physiological one”—a dichotomy many doctors say will discourage genetic testing and worsen racial health disparities.

The “rationale” for the bonus, the new rules read, is that “it is important to acknowledge systemic racism as a root cause for differences in health outcomes between socially-defined racial groups.”

Such premises have found a receptive ear in the Oval Office, which has taken steps to institutionalize them throughout the federal bureaucracy. Hours after his inauguration, President Joe Biden signed an executive order launching a “whole-of-government equity agenda,” one plank of which was the “equitable delivery of government benefits.”

The new bonus scheme, HHS stresses, is “consistent with” this order. It follows a series of steps by the Biden administration to integrate “anti-racism” into government policy: in November, for example, the Department of Homeland Security listed “diversity, equity, and inclusion” as one of its top two priorities, ahead of “cybersecurity.”

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{snip} The new rules add “anti-racism” plans to the list of such activities, which are broken up into “medium” and “high-weighted” categories. “Anti-racism” plans will fall into the second weighting, giving doctors extra incentive to implement them. Under the complicated scoring system, the highest possible bonus is 1.79 percent of a doctor’s Medicare reimbursements.

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Clinics can also boost their reimbursements by implementing “a Trauma-Informed Care Approach to Clinical Practice,” which seeks to “avoid re-traumatizing or triggering past trauma.” That includes “multi-generational trauma, whereby experiences that traumatized earlier generations, such as the genocide of Native American tribes, are passed down” to subsequent generations. In 2018, the New York Times science section called the evidence for multi-generational trauma “circumstantial at best,” saying it “falls well short of demonstrating that past human cruelties affect our physiology today.”

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