Monthly Archives: November 2016

Pence says Trump plans to repeal ACA right ‘out of the gate’

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http://www.beckershospitalreview.com/hospital-management-administration/pence-says-trump-plans-to-repeal-aca-right-out-of-the-gate.html

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President-elect Donald Trump has decided repealing the ACA will officially be among his top priorities when he takes office, Vice President-elect Mike Pence told Chris Wallace on Fox News Sunday.

“Decisions have been made by the President-elect that he wants to focus out of the gate on repealing Obamacare and beginning the process of replacing Obamacare with the kind of free market solutions that he campaigned on,” Mr. Pence said on Fox News.

The Trump-Pence transition team has been working with congressional leaders from both political parties to move Mr. Trump’s “aggressive policy agenda” forward, Mr. Pence said. This weekend Mr. Pence met with Senate Minority Leader Chuck Schumer, D-N.Y., Senate Majority Leader Mitch McConnell, R-Ky., House Minority Leader Nancy Pelosi, D-Calif., and House Speaker Paul Ryan, R-Wis., according to the interview.

Later on the show, Fox News spoke with Sen. Schumer, who said the ACA is one of the issues on which Democrats plan to “oppose [Mr. Trump] tooth and nail.” Sen. Schumer said Mr. Trump would not be successful in his efforts to repeal the healthcare reform law.

“He won’t be able to do it, because now even he, after his meeting with President Obama, said, ‘Oh, I want to keep the good things.’ Well, you can’t keep the good things without keeping [the] ACA,” Sen. Schumer told Fox News.

Scott Becker, publisher of Becker’s Hospital Review, says it is still unclear if Mr. Trump can or will be able to push through an ACA repeal. “It’s a fascinating statement because it’s not clear Republicans have the votes to repeal this without making complicated accommodations on a few levels, particularly for preexisting conditions and some funding issues,” Mr. Becker says.

Fitch: ACA repeal would be credit negative for hospitals

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http://www.beckershospitalreview.com/finance/fitch-aca-repeal-would-be-credit-negative-for-hospitals.html

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http://www.businesswire.com/news/home/20161109006033/en/Fitch-Trump-Victory-Rattles-Healthcare-Industry

 

8 key strategies for improving a hospital’s margins

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http://www.beckershospitalreview.com/hospital-management-administration/8-key-strategies-for-improving-a-hospital-s-margins.html

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As healthcare shifts toward value-based care, hospitals are looking for new ways to improve quality without unnecessarily increasing the cost of care.

“We think less about cost cutting and more about margin improvement,” says Allen Miller, CEO of COPE Health Solutions. “Folks are going to be more successful taking a strategic approach and focusing on improving margins by taking risks and building the type of infrastructure that will support value based contracts through which they take financial risk instead of the traditional cost-cutting approach.”

Here are some key strategies for financial success:

It’s Easy for Obamacare Critics to Overlook the Merits of Medicaid Expansion

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At a national level, the expansion of Medicaid continues to yield benefits. Its coverage was increased, and its quality raised. Some states that have expanded Medicaid are even expecting net savings for the next few years. In states where Medicaid was expanded, hospitals had fewer uninsured visits.

Focusing on only the positives can be as misleading as focusing on only the negatives. Policy decisions, including those involving health, need to be considered in terms of trade-offs. It is true that providing Medicaid can cost the federal government, and even states, a lot of money, which can’t then be spent on other worthy pursuits. It is true that Medicaid reimburses physicians and hospitals less generously, and that it often leaves beneficiaries with fewer choices than private insurance might.

But when we look at the balance sheet for Medicaid — health benefits, financial security, societal improvements through education — it’s not hard to argue that money allocated to Medicaid is well spent.

 

Many Insured Children Lack Essential Health Care, Study Finds

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A new study to be released on Monday by the Children’s Health Fund, a nonprofit based in New York City that expands access to health care for disadvantaged children, found that one in four children in the United States did not have access to essential health care, though a record number of young people now have health insurance.

The report found that 20.3 million people in the nation under the age of 18 lack “access to care that meets modern pediatric standards.”

Guidelines issued by the American Academy of Pediatrics say that all children should get health maintenance visits for immunizations and other preventive services; management of acute and chronic medical conditions; access to mental health support and dental care; and have round-the-clock availability of emergency services and timely access to subspecialists.

While Medicaid and many private insurance plans recommend or require that all of those services be provided, under the umbrella of what is known as the medical home, the study found that millions of insured children are not receiving many of the benefits.

There are many children with insurance who cannot get primary care and those who do can often have problems getting specialty care.

As President-elect Donald J. Trump, a Republican, vows to repeal some, if not all, of the Affordable Care Act, which extended health care coverage to an additional 20 million people, the report’s authors worry that even more children could have trouble receiving the care they need.

“The fact that more than 20 million children in the U.S. experience insurance and noninsurance barriers to getting comprehensive and timely health care is a challenge that needs to get the highest-priority attention from the new administration,” said the report’s lead author, Dr. Irwin Redlener, president of the nonprofit Children’s Health Fund and a professor of pediatrics and health policy and management at Columbia University.

Over the past two decades, the number of children without health insurance has steadily decreased to 3.3 million last year from around 10 million in 1997, according to an analysis of federal data and the federal government’s 2015 National Health Interview Survey.

The effort to extend coverage began 50 years ago with the creation of Medicaid, which provides health insurance for the poor. It continued more recently with the Children’s Health Insurance Program, which offers low-cost coverage to those who make too much money to qualify for Medicaid and, under the Obama administration, with the Affordable Care Act, offering subsidized coverage and state exchanges.

 

Obamacare repeal plan stokes fears of market collapse

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http://www.politico.com/story/2016/11/obamacare-repeal-market-collapses-231653?utm_campaign=CHL%3A+Daily+Edition&utm_source=hs_email&utm_medium=email&utm_content=37969677&_hsenc=p2ANqtz–Wv-16E4bE7iT4jhF2j2QKWBhCJZPBLuy-TBTKYxxVNSL8KAVSAyRmDFndXujD1e6r6JMx9BX3zcgMSf3biYBAMLyJug&_hsmi=37969677

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Republicans warned for years that Obamacare would blow up the nation’s individual insurance market. Instead, their own rush to repeal the health care law may be what triggers that death spiral.

GOP lawmakers say they plan to repeal the Affordable Care Act as soon as President-elect Donald Trump takes office, including a transition period of a year or two before it takes effect. That way, they satisfy their base while giving notice to 20 million Obamacare customers that they must find other coverage options.

But repealing the law without a replacement is likely to spook health insurers, who might bolt from the markets prematurely to avoid losses as some people stop paying their premiums, while other people rush to have expensive medical procedures before losing coverage. Insurers would have little incentive to stick around without knowing what to expect at the end of the transition. And that could spell chaos for consumers.

“The discussion right now about repeal and replacement is making the market very, very nervous,” said Washington Insurance Commissioner Mike Kreidler, a Democrat. “I would not be surprised to see the potential for a stampede to exit the market.”

Even if Congress delays immediate action to kill the health care law, Obamacare insurers would have just a few months to decide whether to stay in the law’s marketplaces for 2018. Deep uncertainty about the Republicans’ Obamacare replacement could drive out those companies, cutting off insurance for, potentially, millions of customers.

“A repeal that kicks the can on replace would put the market in serious jeopardy, and the American people will hold them accountable for the results,” Topher Spiro, who heads health policy at the left-leaning Center for American Progress, said on a call with Obamacare supporters last week.

Uncertainty about Obamacare’s future is occurring against the backdrop of strong demand for coverage. More than 1 million people signed up through HealthCare.gov in the first two weeks of the current enrollment season, including 100,000 who enrolled the day after the election, according to the Department of Health and Human Services. The administration projects that 13.8 million people will participate this season, which ends about two weeks after Trump takes office. Millions more — including young adults on their parents’ policies and those in expanded Medicaid — will also get coverage this cycle.

Uncertain Fate Of Health Law Giving Health Industry Heartburn

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Uncertain Fate Of Health Law Giving Health Industry Heartburn

WASHINGTON, DC - NOVEMBER 10: President-elect Donald Trump (L) talks after a meeting with U.S. President Barack Obama (R) in the Oval Office November 10, 2016 in Washington, DC. Trump is scheduled to meet with members of the Republican leadership in Congress later today on Capitol Hill. (Photo by Win McNamee/Getty Images)

Six years into building its business around the Affordable Care Act, the nation’s $3 trillion health care industry may be losing that political playbook.

Industry leaders, like many voters, were stunned by the election of Donald Trump and unprepared for Republicans’ plans to “repeal and replace” Obamacare.

In addition, Trump’s vague and sometimes conflicting statements on health policy have left industry officials guessing as to the details of any substitute for the federal health law.

“It will be repealed and replaced,” Trump said Sunday in an interview on CBS’ “60 Minutes.” At the same time, he vowed to preserve popular provisions of the law like ensuring that people with preexisting conditions can get insurance and allowing young adults to stay on their parents’ health plans.

Charles (Chip) Kahn, chief executive of the Federation of American Hospitals, said that before the election, health groups had not been meeting with Republicans about a rewrite of the law “because the working assumption was we had a program that wasn’t going anywhere. That working assumption is now no longer operative.”

Upending the health law plays havoc with a health industry that had invested heavily in strategies geared to the ACA’s financial incentives. The flipped script initially left some industry groups speechless. Others issued bland statements pledging cooperation with the next administration as they awaited greater clarity from the next president.

Said Donald Crane, who heads CAPG, a national trade group for physician organizations: “Nobody was ready for this. We didn’t have a Plan B.”

The results appear to have rattled the fragile industry coalition that the Obama administration carefully crafted to support the law. Looking ahead, some health sectors might have even more reason to worry.

The hospital industry may be the most vulnerable to proposed changes, which could result in millions of Americans losing health coverage, both through the insurance exchanges and expansion in the Medicaid program for those with lower incomes.