Obama’s health plan short on details

BOULDER – With all the uncertainties floating around about the government’s highly anticipated health-care reform, it’s hard for area hospital executives to plan ahead for changes that undoubtedly will impact them.

“We’re going to have to change,´ said Dave Hamm, Exempla Good Samaritan Medical Center’s chief executive officer.

Since running for president, Barack Obama has vowed to change the health-care system, make it more efficient, ensure more American’s are insured, incorporate electronic medical records and more.

Now, with Sen. Edward M. Kennedy, D-Mass., and Sen. Christopher J. Dodd, D-Conn., helping lead the charge, the bill is making the rounds through various committees and governing bodies.

But while area hospital execs are trying to keep tabs on it, most say bill facets are changing so much it’s hard to accurately track and plan accordingly.

“I think the details need to emerge a little more,´ said Dave Gehant, Boulder Community Hospital’s chief executive officer.

While things are still fuzzy, some aspects of the proposed plan, such as speeding up electronic medical record implementation, lowering reimbursement rates for Medicare and Medicaid, and decreasing the number of uninsured or underinsured Americans are among the regularly discussed items.

“I think one of my primary concern is how, overall, the government can afford to pay for whatever plan they develop,´ said Mitchell Carson, Longmont United Hospital’s president and chief executive officer. “How do you come up with an affordable health-care plan for our country?”

One aspect of the bill many believe to be likely is a lower reimbursement rate for Medicare and Medicaid.

“They’re thinking about lowering the reimbursement for Medicare, and that’s a big hit,´ said John Sackett, Avista Adventist Hospital’s president and chief executive officer.

If that happens, that would mean hospitals would likely charge non-Medicare and non-Medicaid patients more than they do currently to make up for the bigger loss. And when health-care costs already are increasing, it makes it even harder for some people to pay the premiums.

Gehant worries about that happening because employers and individuals won’t want to pay higher costs. Health providers would then have to find innovative ways to reduce costs without reducing quality of care, he said.

Coupled with lower reimbursements, a highly talked about facet to the possible plan is ensuring all Americans have health insurance. Where the money would come from seems to still be up in the air, but local executives embrace the idea.

“There’s a chance there would be fewer uninsured, and that would help us,” Sackett said.

It would also help people currently uninsured receive the help they can’t afford.

“I think this will remove that barrier, and many more people will be able to go to physician clinics,” Gehant said.

The details are yet to be seen, but if the government funds a Medicaid-type program, area execs are torn on whether or not that would be beneficial.

If hospitals are at least partially reimbursed for patients that previously had no insurance, patients with private insurance may not be charged as much to make up for the difference, Sackett said.

Gehant said he wouldn’t anticipate much of a change, if any, to his hospital’s budget if that was the case.

“I think it’ll be more budget neutral to hospitals,” he said. “I certainly do not see this as a windfall to hospitals in any way.”

Sackett fears if the government-run option, such as a Medicaid-type program, is cheaper, more people will drop private insurance and switch to the public option essentially eliminating private insurance. Then people are left with a government-run insurance plan.

“I know that there are a lot of smart people looking at this, and for them to suggest that this wouldn’t happen – they know better,” he said.

Electronic medical records, though, is one aspect of the bill that’s generally supported by local hospitals.

“We’re really looking forward to the advent of electronic medical record for all patients,” Gehant said.

Not only will electronic medical records help eliminate prescription errors due to sloppy handwriting; it’ll also help reduce redundancy, improve speed and accuracy of diagnosis and more.

Exempla Good Samaritan, one hospital that is already using electronic medical records throughout much of its operations, is ahead of the curve. While stimulus money was earmarked for implementation of records, nothing has been delivered, the CEOs said.

Other changes rumored to happen include eliminating the “pre-existing conditions” clause so that health insurers would have to accept anyone. Another is a bundled payment plan where a hospital would receive a one-time payment for a given procedure, such as cardiac bypass surgery, no matter if the ailment reoccurred or not.

There’s also talk of helping boost primary-care physicians’ salaries to help boost the number of doctors managing chronic illness and place an emphasis on preventive care rather than focusing on fixing ailments that already surfaced, Sackett said.

Regardless of what facets are in the final bill, the four executives agree they’ll adapt to any changes. It may come with a steep learning curve, but some form of change is needed within the health care industry.

“From my standpoint, we certainly think there needs to be health care reform,” Carson said.

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