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VOL. 128 | NO. 68 | Monday, April 08, 2013

Health Care Challenge

Seminar examines complex issues surrounding Affordable Care Act

By MICHAEL WADDELL

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Bill Hannah of DHG Healthcare speaks during a panel discussion for The Daily News Seminar on Health Care Reform, held last week at the Memphis Brooks Museum of Art.

(Photos: Lance Murphey)

To cap off National Public Health Week, The Daily News held an in-depth discussion about health care reform and the daunting task of trying to digest and comprehend the new Affordable Care Act, which encompasses more than 2,800 pages of law and more than 100,000 pages of regulations and rules.

The Health Care Reform seminar – held Thursday, April 4, at the Memphis Brooks Museum of Art – was led by Eric Barnes, publisher of The Daily News and The Memphis News. The keynote presentation came from Susan Cooper, chief integration officer and senior vice president of ambulatory care at The Regional Medical Center at Memphis.

“If we really want to transform the health of our communities, we need to work upstream and really focus on health and look at preventative strategies that can put in place to diminish the need for people to have to seek care at a higher level of services like a hospital,” said Cooper, a former commissioner of health for the state of Tennessee.

Roughly $2.7 trillion is spent on health care each year in the U.S., representing more than 18 percent of the overall GDP, and as much as 75 percent of that money is spent treating preventable diseases like diabetes, heart disease and hypertension – all categories the U.S. ranks highly in when compared to the rest of the world, along with infant mortality rate and life expectancy.

“What I propose is that we don’t have a health care system, we have a sick care system,” Cooper said. “If we are really going to change the way expenses and the trajectory of health occurs, then we have to change the way that we deliver care.”

Recent positive signs include access to new preventative services like mammograms and colonoscopies with no co-pays and investments for primary care training.

Cooper expects to see expanded coverage for more than 30 million people starting next year, with no annual limits on coverage or benefits, no more 90-day waiting periods for coverage, new annual out-of-pocket maximums, no more pre-existing condition clauses, and group “Pay or Play” protections for part-time workers.

She hopes to see some Medicaid expansion in 2014. More than 40 million adults said they did not get some form of needed health care treatment in the past year due to cost, and an estimated 48,000 people died last year due to lack of health insurance.

Susan Cooper, chief integration officer and senior vice president of Ambulatory Care at The Regional Medical Center at Memphis, delivers the keynote presentation at The Daily News Seminar on Health Care Reform on Thursday at the Memphis Brooks Museum of Art.

“If full expansion takes place, we would see about 1.3 million people covered by the year 2020,” she said. “Combined with other provisions of the Affordable Care Act, these expansions would reduce the number of uninsured by about 48 percent.”

In Shelby County it would mean coverage for approximately 74,000 non-elderly people age 18 to 64, and in Tennessee 18,000 jobs would be created.

Without Medicaid expansion, hospitals are concerned about how they will continue to deliver care to the uninsured. According to the Tennessee Hospital Association, the cuts without Medicaid expansion would equal $2.9 billion over the next five years and $7.4 billion over the next 10 years, with an estimated 7,000 to 11,000 jobs lost in Tennessee.

Cooper envisions a health care system where the patient is treated by a team of doctors that are familiar with their specific medical history, and where patients are more engaged in their care.

“If we don’t control health care, our economy is going to continue to go into a fiscal decline,” said Cooper, who pointed out that overall health care costs are expected to rise to 21 percent of the country’s GDP by 2023. “We have to transform how we deliver care. Coverage expansion without system reform will not work.”

The seminar’s featured panelists included Geoffrey Lindley, attorney with Rainey Kizer Reviere & Bell PLC; Timothy Finnell, president of Group Benefits LLC; Zach Chandler, vice president with Baptist Memorial Health Care Corp.; and Bill Hannah, principal of DHG Healthcare.

All see major challenges resulting from the health care reform.

“The challenge we have before us is completely redesigning the health care system and how delivery of care occurs,” Chandler said. “As our country, our businesses and our community are challenged financially, we understand that the delivery of care we have had in the past is just not going to work.”

Baptist, through its growing network of nearly 500 physicians, is focusing on preventative care and wellness programs while striving to engage physicians, patients and their families.

Finnell and Lindley see deciphering the large volume of the law’s provisions as the biggest hurdle.

“The biggest challenge is trying to understand the law,” said Finnell, who believes there is too much misinformation, making it difficult for individuals and businesses to comprehend.

“There’s a lot here to digest, with whatever perspective you bring to it,” agreed Lindley. “It’s something that affects everyone in every industry.”

Hannah sees the messy health care ecosystem as unsustainable.

“The ecosystem cannot survive and is not sustainable at its current evolution,” said Hannah, who thinks change will come from physician-led practices as opposed to hospital-led systems. “The natural progression tends to be for consolidation.”

The event was sponsored by Dixon Hughes Goodman LLP, Group Benefits LLC and Rainey Kizer Reviere & Bell PLC.

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