
Cartoon – Salary Negotiation Today





Click to access 2019-cfo-outlook-healthcare.pdf

Many senior finance executives are not fully prepared to manage the financial impact of evolving business conditions in today’s healthcare environment, according to a survey by strategic and financial consulting firm Kaufman Hall.
The survey, conducted in September and October, asked CFOs, vice presidents of finance, directors of finance, and other senior finance executives more than 20 questions to gauge performance management progress and trends. Participants represented more than 160 U.S. hospitals, health systems, and other healthcare organizations.
Five findings:
1. Only 13 percent of respondents said their organizations are very prepared to manage evolving payment and delivery models with the financial planning processes and tools now available.
2. Additionally, only 23 percent said they are very confident that their teams can quickly and easily adjust to strategies and plans.
3. Ninety-six percent of respondents said they believe their organizations should be making greater efforts to leverage financial and operational data as part of decision-making.
4. Cost reduction and management is the biggest priority for senior finance executives this year, followed by predicting and managing changing payment models.
5. Along those lines, more than half of respondents cited the following as top improvement priorities for financial planning and analysis:


Pipeline Health, a privately held hospital ownership and management company based in Los Angeles, has acquired Arlington-based Texas Health Resources’ majority stake in 22 freestanding emergency rooms, according to The Dallas Morning News.
Pipeline Health will jointly own the freestanding ERs, which are in the Dallas-Forth Worth area, with Lewisville, Texas-based Adeptus Health. Adeptus was acquired by a hedge fund in 2017 after filing for Chapter 11 bankruptcy.
The group of freestanding ERs will be renamed City Hospital Emergency Care, and they will become outpatient ERs of City Hospital at White Rock in Dallas, which Pipeline owns.

Democratic presidential contender Sen. Kamala Harris wants to “move on” from the current healthcare system in favor of a plan that would roll everyone in the U.S. onto a government plan known as “Medicare for all,” doing away with private health insurance.
As the California Democrat and others in her party make their case, however, they will face considerable opposition not only in the insurance industry, but across the healthcare sector, which would see massive upheaval from the plan. And polling suggests that the public, roughly half of which relies on private insurance, isn’t quite on board.
Drug companies, insurers, doctors, and hospitals have united in recent months to fight national government healthcare. One healthcare industry group, called the Partnership for America’s Health Care Future, has launched a five-figure digital ad campaign arguing that “Medicare for all” would cause massive disruption, higher taxes, lower quality care, and less choice for patients. It plans to spend six figures bashing “Medicare for all” over the course of 2019.
“Whether it’s called Medicare for all, single payer, or a public option, one-size-fits-all healthcare will mean all Americans have less choice and control over the doctors, treatments, and coverage,” said Lauren Crawford Shaver, the group’s executive director.
Other candidates for the Democratic nomination, such as Sens. Elizabeth Warren of Massachusetts and Kirsten Gillibrand of New York, are, like Harris, co-sponsors of the Medicare for All Act, legislation led by Sen. Bernie Sanders, I-Vt. Although it has “Medicare” in the name, the bill would go much further than current Medicare, which covers adults 65 and older and people with disabilities. It would pay for emergency surgery, prescription drugs, mental healthcare, and eye care without a copay.
Children would be enrolled in the government plan soon after the the bill’s passage, and the rest would be gradually phased in after four years. This would mean that roughly half of the U.S. population, the 177 million people in the U.S. covered by private health insurance mostly through work, would be moved onto a government plan. Employers would pay higher taxes rather than pay for private plans.
In defending the need for a government system, Sanders has blasted insurance companies, saying upon unveiling the bill that they “make billions of dollars in profits and make industry CEOs extremely wealthy.”
But healthcare providers, not just insurers, benefit from the current fragmented system, in which insurance is purchased by employers, the government, and individuals. They charge private insurers more to make up for the gap left by patients who are uninsured or are on government programs, which pay less for their services.
If all privately insured individuals were to have Medicare instead, and if it were to pay the same rates it does now, then doctors and hospitals would see big losses caring for patients who moved from private coverage to the government plan. Healthcare providers have said that if taxes don’t go up to pay for the difference, then doctors and hospitals will face pay cuts and layoffs, leading to facility closures and long lines for care.
Hospitals serve as the main employer in many communities. For patients, that would mean losing not only a healthcare plan they might be satisfied with, but also doctors they worked with for years or hospitals they relied on in their communities.
The Medicare for All Act has not been scored by the Congressional Budget Office, but analyses from the Mercatus Center at George Mason University and the left-leaning Urban Institute found it would raise government spending over a decade by $32.6 trillion.
Overall healthcare spending, though, would actually fall by $2 trillion, as private spending on healthcare would collapse. The cut would be achieved, however, through paying 40 percent less to providers than what they were getting from private insurance.
Another obstacle to “Medicare for all” is the fact that the public isn’t fully convinced by the idea of nixing private insurance, a recent poll from the Kaiser Family Foundation shows. Initially, 56 percent of those polled favored the Medicare for All Act, but then when they learned it would do away with private health insurance, the support fell to 37 percent.
Candidates are going to face pushback within their party. House Speaker Nancy Pelosi and other Democratic leaders have not embraced government healthcare, instead pushing for adding funding to Obamacare.
But proponents of allowing the government to have a more extensive role in healthcare point out that waste is prevalent in the current system. Patients receive unnecessary medical care, such as repeated tests or surgeries that either don’t make them healthier or even make them worse.
These proponents agree with Harris that health insurance companies are unnecessary. Wendell Potter, an advocate of a government-financed healthcare system and president of the Business Initiative for Health Policy, said in a statement that polling results show the healthcare industry’s misinformation campaign to spread “fear, uncertainty, and doubt” was effective. He said that commercial health insurance companies don’t have an incentive to lower healthcare costs and make sure patients can access care.
Potter, a former health insurance executive, described how the information campaign worked, saying the goal was to “make people believe that private health insurance companies were a necessary part of the healthcare system, and to scare them into thinking that a ‘Medicare for all’ system was expensive and impractical, and that it would cause a significant drop off in the quality of care.”
Dems hit GOP on pre-existing conditions at panel’s first policy hearing
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The powerful House Ways and Means Committee used its first policy hearing of the new Congress to hammer Republicans on pre-existing conditions, an issue that helped propel Democrats into the majority during the 2018 midterm elections.
Democratic panel members highlighted actions by the Trump administration that they argue have hurt people with pre-existing conditions, like the expansion of non-ObamaCare plans that could draw healthy people from the markets, raising premiums for those left behind.
The administration has expanded access to association and short-term health plans, which cost less than ObamaCare plans but cover fewer services. Republicans say they provide an off-ramp for consumers who can’t afford ObamaCare plans.
The witness invited by Republicans, Rob Robertson with the Nebraska Farm Bureau, said its newly developed association health plan “meets the needs of our members,” who can’t afford ObamaCare plans.
“We’re in this for the long term,” he told lawmakers. “We want to reduce costs, and the costs in the individual market are very, very high.”
ObamaCare’s popular consumer protections became the centerpiece of the November midterms after 20 Republican-led states sued to overturn the 2010 health care law, known as the Affordable Care Act (ACA).
Democrats tied congressional Republicans to the lawsuit after the Trump administration declined to defend ObamaCare and argued that those protections are unconstitutional.
Republicans say there are different ways to cover people with pre-existing conditions, like high-risk pools, which were banned after ObamaCare was implemented. Some pools had caps on coverage and long-waiting lists.
GOP committee members called Tuesday’s hearing political theatre, arguing they also support pre-existing protections but want to lower ObamaCare’s costs.
“Everyone up here wants protections for people with pre-existing conditions. Always have, always will,” said Rep. Devin Nunes (R-Calif.), ranking member of the health subcommittee. “We should be careful that we’re not stoking fear that someone is going to lose their health insurance. We have a responsibility to come up with a better health care system because ObamaCare is not the solution.”
Democrats on Tuesday said the GOP proposals aren’t serious.
Republicans have “political amnesia” and have “forgotten what it was like before the ACA,” said Rep. Lloyd Doggett (D-Texas), chairman of the health subcommittee. “Those with a diagnosis of a serious disease would also get a diagnosis of financial ruin. There were no protections for them before the ACA.”
Some Democratic panel members appealed to the emotional side of the health care debate, with one lawmaker announcing her cancer diagnosis at the hearing.
“This is a cancer I will live with for the rest of my life, but, because of my high-quality healthcare and insurance coverage, it is not a cancer I will die from,” said Rep. Gwen Moore (D-Wis.), 67.
Tensions ran high at times during Tuesday’s hearing, with members re-litigating the 2010 passage of ObamaCare and repeated GOP efforts to repeal it.
“Not one Republican up here supports pre-existing protections for the American people,” said Rep. Brian Higgins (D-N.Y.), who at times pounded his fist on the dais.
That drew a testy response from Rep. Tom Reed (R-Pa.), who said Republicans “heard the voices and the fear” from voters in the 2018 midterms when “this issue became the centerpiece.”
“We listened to this American people, as Republicans,” he said.

