The federal Patient Protection and Affordable Care Act signed into law in 2010 is driving health-care industry changes in 2013, both directly and indirectly, local executives said.
At Boulder Community Hospital, the new Anderson Medical Center will feature an outpatient surgery center — a key piece of the hospital’s plan to move its acute-care services over the next several years, said Bill Munson, chief financial officer. When all is said and done, the hospital’s main campus will move to the Foothills campus on the northeast corner of Arapahoe Avenue and Foothills Parkway from its current location on Broadway.
“As we look at the future of health-care reform, it’s about high quality and efficiency,” Munson said. “The Foothills campus is a really important move.”
A more direct effect of federal policy changes in 2013 could be a potential $300,000 drop in Medicare reimbursements at the hospital, Munson said.
Under the Affordable Care Act passed in 2010 — often now referred to as “federal health-care reform” or “Obamacare” — hospitals nationwide must meet defined performance objectives such as lower readmission rates for Medicare patients, Munson said.
While Boulder Community was the only hospital in the county to not be penalized in 2012 in relation to the performance objectives, it’s still a concern, Munson said. The potential reimbursement reduction amount was calculated by the Colorado Hospital Association, an industry trade group.
“It’s not like we earn it or avoid it, it just happens,” Munson said.
Another of the key federal policy changes relates to lowering the cost of health care in terms of insurance premiums, said John Sackett, chief executive of Avista Adventist Hospital in Louisville.
In response, the health-care industry is moving to the “medical home” concept, in which insurance companies pay doctors monthly amounts for enrolled “members,” Sackett said. The idea is to focus on keeping potential patients well, Sackett said.
Avista is in the middle of a more than $1 million remodel expected to wrap up this year, Sackett said. Rooms in the medical/surgical unit and in the pediatrics unit of the hospital are getting upgrades to keep things modern for patients, Sackett said. The kitchen and the cafeteria also are getting a face-lift, he said.
If insurance prices go up in 2013, patients may delay getting the care they need, a concern for David Hamm, president and chief executive at Exempla Good Samaritan Medical Center in Lafayette.
That can cause more general emergency-room use at hospitals, according to many in the industry.
Insurance companies and state workers will continue to work on a statewide online health-insurance exchange that is scheduled to go into effect in 2014.
In addition, a statewide electronic medical records system put together by the nonprofit Colorado Regional Health Information Organization, or CORHIO, continues to market itself to attract customers. The exchange is getting state and federal grants to get up and running, but it’s expected to be self-sustaining in the next couple of years through fees from doctors and hospitals.