TRENDS
It was noted during my recent visit to Washington, D.C. that our new president and a stronger, Democratic-controlled Congress are off to a fast start. While there are many serious, competing issues to draw the attention of our current American leaders, I can assure you that health care is within the top five and will be an area of serious discussion - and far reaching decisions.
Expanding the government's involvement as a payor to reach a greater part of the population is at the heart of many health reform discussions. The government payors for this expanding government involvement are Medicare and Medicaid, with most of the shift described below captured by Medicare. Here are some ways the government will expand:
- Capture the uninsured and underinsured
- Gradually capture the self employed, self insured and small business employers as the government payor competes favorably with alternatives in the commercial sector
- Capture federal, and perhaps state and local government employees, as the federal government adds a competitively priced, government-run choice along with those currently available
- Gradual shift of those insured in employer paid health insurance who "opt out" for better first-dollar coverage in a government program.
Concurrent with these payor trends, the federal government will accelerate efforts to define what is quality care, to demand data from providers for what the government believes measures the quality care, and to increase or reduce total reimbursement amounts to the provider based on their quality performance.
So, in very simple terms, the federal government will be setting payment rates for an increasing percentage of your revenue and will force changes in your process of patient care.
This is where "you" need to step into the discussion. It is only through your personal commitment to talk with your elected representatives and their staffs that the interests of physician owned ambulatory surgery centers and hospitals will have the opportunity to survive and thrive in the unfolding health care system of the future. And this conversation with your elected representatives should be an ongoing dialogue, not a one-time "download."
During the past year, Nueterra has provided tremendous leadership in supporting many efforts to influence Congress and the executive branch. Moreover, many of Nueterra physician investors and center staff are engaged in the dialog I describe above. Now we need to broaden the number of Nueterra facilities that are committed to this advocacy effort and deepen the number of professionals at each facility who are involved in contacting their elected officials. Our physician and administrator champions need and deserve the extra effort of the nurses, physicians and business support professionals who enjoy one of the best work sites in the U.S. health care system.
What should you talk about with your elected representatives? Patient satisfaction, high quality care, efficient use of professional resources, low cost to the consumer and the payer are all areas of strength for your facility. This is the essential message your representative and their staff want to know - what is it that you do and why is it so good?Written by Craig Jeffries, esq., Nueterra public policy consultant