From the CEO
Since being elected president in November, Barack Obama has made it very clear that he intends to move quickly to address his top priorities, including healthcare reform. During the campaign Obama said reducing healthcare costs and expanding coverage would be among his top priorities if he were elected. But with the ongoing economic and financial crisis, some experts are questioning whether Obama will be able to achieve his healthcare goals quickly. Given the cost and complexity of the significant reforms Obama he has proposed, changes may be phased in over time.
Regardless of the speed with which he moves, Obama's plan will likely impact ASCs and physician-owned hospitals in several ways. Here's how:
- Any reform proposal will likely try to mandate greater transparency of physician investments, quality matrixes, and provider charges.
- Quality measurements will become more important. Obama's plan would require providers to collect and publicly report measures of healthcare costs and quality, such as preventable errors, disparities, staffing data and infection rates. It would also require insurers to disclose the percentage of premiums used for patient care versus administrative costs.
- More people will be insured. Obama has said he wants to reduce the number of uninsured Americans, which currently stands at about 46 million. He would do this by requiring all employers to either provide healthcare insurance to their employees or to contribute toward the cost of coverage for employees. Obama also wants to mandate health insurance for all children. His plan would create a National Health Insurance Exchange to give individuals and small businesses the opportunity to purchase affordable private or public plans.
- Electronic health records will receive increased funding as we move toward a phased-in implementation of a new electronic health information system. A major IT demonstration for physicians will start this year (2009) that will provide payments to participating practices based on electronic health record functions used to manage the care of patients. Ultimately, the investment could be as much as $10 billion a year for the next five years.
- Medicare physician payments (SGR) will also be a likely target of reform legislation.
However, other than the investment in electronic health information, experts do not anticipate that we will see any significant increase in funding for new healthcare initiatives or increased reimbursements. On the contrary, reimbursement rates will likely continue to shrink to provide additional funds for expanded access to care. Expect to be rewarded if you perform well and penalized if you do not.
Reform legislation efforts will be led in the Senate by Sen. Ron Wyden (D-OR) and Sen. Edward Kennedy (D-MA). Wyden is widely seen as the starting point for any fundamental, national reform legislation and, most significantly, the Congressional Budget Office has already indicated his plan will save money. And Kennedy has had discussions with a variety of stakeholders to build a framework under a "one-bill" approach, which would combine various healthcare reform initiatives into a single bill. Sen. Baucus has also put forward recommendation that incorporate ideas from the Obama campaign.
While reform appears to be inevitable, ASCs have an opportunity to increase their political effectiveness to improve recognition and support from Democratic senators who now are supportive of community hospitals. Moreover, given their large numbers and the 35 percent discount on services that they provide the governments ASCs have an opportunity to build their public relations efforts to underscore these facts and the quality and patient satisfaction for their services. Existing physician-owned hospitals will likely have a very difficult time not directly because of Obama as president but because of the loss of a counterbalance to Democratic control in Congress. Nueterra will continue to take a leadership role in working with key legislators to ensure they understand the importance of physician-owned healthcare facilities in the overall healthcare system.
Written by John Schario, CEO, Nueterra Healthcare