Doctors Group Warns Against Loss Of Coverage From ObamaCare Repeal

Doctors group warns against loss of coverage from ObamaCare repeal

Doctors group warns against loss of coverage from ObamaCare repeal

The country’s leading doctors group is urging Republicans to take steps to ensure that people do not lose their health insurance once ObamaCare is repealed.

The American Medical Association (AMA), wrote a letter to congressional leaders on Tuesday calling for the gains in coverage from ObamaCare, which has expanded insurance to 20 million people, to be preserved.

“In considering opportunities to make coverage more affordable and accessible to all Americans, it is essential that gains in the number of Americans with health insurance coverage be maintained,” AMA CEO Dr. James Madara wrote leaders in both parties.

“Consistent with this core principle, we believe that before any action is taken through reconciliation or other means that would potentially alter coverage, policymakers should lay out for the American people, in reasonable detail, what will replace current policies,” Madara continued.

“Patients and other stakeholders should be able to clearly compare current policy to new proposals so they can make informed decisions about whether it represents a step forward in the ongoing process of health reform.”

The AMA’s position is at odds with Republicans’ current plan. The GOP is moving forward this month with plans to repeal ObamaCare without a replacement, but delay repeal going into effect for a few years to buy time for drafting an alternative.

The American Hospital Association, meanwhile, warned in a report last month of an “unprecedented public health crisis” from people losing coverage under ObamaCare repeal.

The AMA added that ObamaCare is “imperfect” and said it would favor policies if they increased coverage, choices and affordability.

After Obama, Some Health Reforms May Prove Lasting

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Fragments of bone and cartilage arced across the operating room as Dr. R. Michael Meneghini drilled into the knee of his first patient at a hospital here at dawn. Within an hour, the 66-year-old woman had a replacement joint made of titanium and cobalt chrome, and she was sent home the next day.

But the Obama administration was watching over her caregivers’ shoulders. If, over three months, her medical costs exceeded a target amount set by President Obama’s health regulators in Washington, Dr. Meneghini’s employer, Indiana University Health, stood to lose money.

Such efforts to squeeze spending out of the nation’s health system may well remain as Mr. Obama exits the West Wing and Donald J. Trump takes his seat in the Oval Office. The Affordable Care Act is in extreme peril, and Mr. Obama will meet with congressional Democrats at the Capitol on Wednesday to try to devise a strategy that can stave off the quick-strike repeal of the health law that Republicans plan for the opening months of the Trump administration.

But the transformation of American health care that has occurred over the last eight years — touching every aspect of the system, down to a knee replacement in the nation’s heartland — has a momentum that could prove impossible to stop.

Expanding insurance coverage to more than 20 million Americans is among Mr. Obama’s proudest accomplishments, but the changes he has pushed go deeper. They have had an impact on every level of care — from what happens during checkups and surgery to how doctors and hospitals are paid, how their results are measured and how they work together.

“From the moment I first set foot in the Oval Office in February 2009, the president told me that the law can’t be just about covering the uninsured, but that it also has to be about changing the way care is delivered,” said Nancy-Ann DeParle, who as a White House aide helped lead the effort to pass and carry out the health law. His message, she said: “I don’t want to cover everyone and just put them in the same creaky old delivery system.”

Changes in the delivery system already affect far more people than the law’s higher-profile coverage gains. To visit IU Health, the largest health care provider in Indiana, with 15 hospitals and 8,700 doctors, is to see those changes up close. Its leaders have started moving away from fee-for-service medicine, where every procedure, examination and prescription fetches a price. The emphasis now is on preventive care, on taking responsibility for the health of patients not only in the hospital, but also in the community.

Outlook for 2017: Healthcare re-reform

http://www.modernhealthcare.com/article/20161231/MAGAZINE/312319988/outlook-for-2017-healthcare-re-reform?utm_source=RealClearHealth%20Morning%20Scan&utm_campaign=be01ccd91c-EMAIL_CAMPAIGN_2017_01_03&utm_medium=email&utm_term=0_b4baf6b587-be01ccd91c-84752421

2017 had been shaping up as a year focused on fixing the Affordable Care Act’s insurance markets, slowing prescription drug price hikes, expanding Medicaid, improving mental healthcare and spreading value-based payment and delivery.

Suddenly there’s a new, more conservative agenda. And almost everything in healthcare is up in the air.

 

Insurers and providers were counting on continuing to add paying customers under the ACA’s premium subsidy framework, with more states expanding Medicaid to low-income adults. But after the surprise presidential victory of Republican Donald Trump, industry groups have no clear idea what the new framework will be if Trump and the Republican Congress make good on their pledge to repeal and replace Obamacare.

Beyond that, there’s great uncertainty whether and at what level Republicans will fund a wide range of health programs, including medical research, mental health and addiction services, public health, community health centers and the Children’s Health Insurance Program. Trump’s picks for cabinet-level posts, notably Rep. Mick Mulvaney (R-S.C.) at the Office of Management and Budget, are no fans of government social spending.

“It’s hard to plan a business with this many outstanding questions,” said Ceci Connolly, CEO of the Alliance for Community Health Plans, which represents not-for-profit insurers.

Republican experts say there’s no question Congress will push to repeal the ACA via a party-line, expedited budget bill. It’s likely they’ll also try to erase or roll back the law’s Medicaid expansion. But these observers acknowledge that congressional GOP leaders themselves don’t know what they’re going to put in the ACA’s place—or precisely how they’ll do it.

“They’re working through that,” said Dean Rosen, a Republican lobbyist who formerly served as a senior Republican Senate staffer. “Republicans will own the changes, and they have to be very careful they don’t find themselves in the same position as the Obama administration, defending an unpopular, partisan piece of legislation.”

More than 50 million adults with pre-existing conditions would lose coverage in wake of Obamacare repeal, Kaiser study says

http://www.healthcarefinancenews.com/news/more-50-million-adults-pre-existing-conditions-would-lose-coverage-wake-obamacare-repeal-kaiser

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Kaiser Family Foundation poll found the 53 percent of people reported that they or someone in their household has a pre-existing condition.

Crossing the Political Chasm

http://www.commonwealthfund.org/publications/blog/2016/dec/crossing-the-political-chasm

As a new chapter in the saga of U.S. health care reform is written in the coming year, it’s worth remembering that, behind the layers of jargon and obscure political maneuvers, the consequences of success—and of failure—will be shared by individuals and groups across our society…regardless of ideology, demography, or geography.

Five-year decline in hospital-acquired conditions leads to $28B in savings

http://www.fiercehealthcare.com/healthcare/five-year-decline-hospital-acquired-conditions-leads-to-28b-savings

Fewer patients have died due to hospital-acquired conditions over the past five years and hospitals saved more than $28 billion in healthcare costs during the same time period, according to a new federal government report.

The U.S. Department of Health and Human Services credits the 21 percent decline in hospital-acquired conditions in part to the provisions of the Affordable Care Act.

“The Affordable Care Act gave us tools to build a better healthcare system that protects patients, improves quality, and makes the most of our healthcare dollars and those tools are generating results,” said HHS Secretary Sylvia M. Burwell in the announcement. “Today’s report shows us hundreds of thousands of Americans have been spared from deadly hospital-acquired conditions, resulting in thousands of lives saved and billions of dollars saved.”

Indeed, the report, “National Scorecard on Rates of Hospital-Acquired Conditions,” by the Agency for Healthcare Research and Quality, finds that roughly 125,000 fewer patients died during 2010 to 2015. In total, hospital patients experienced more than 3 million fewer hospital-acquired conditions, such as adverse drug events, catheter-associated urinary tract infections, central line associated bloodstream infections, pressure ulcers and surgical site infections, during that time period.

Q&A: Cleveland Clinic CEO to Join Trump Advisory Panel

http://www.healthleadersmedia.com/leadership/qa-cleveland-clinic-ceo-join-trump-advisory-panel?spMailingID=10066722&spUserID=MTY3ODg4NTg1MzQ4S0&spJobID=1061461419&spReportId=MTA2MTQ2MTQxOQS2

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Toby Cosgrove, MD, discusses his concerns about the regulatory burdens on healthcare providers ahead of serving on the president-elect’s “strategic and policy forum.”

This is the first in of a series covering the Shaping of Healthcare’s Future in the Trump era. As the new administration prepares to take office, HealthLeaders Media will continue to talk with healthcare leaders about the challenges and opportunities for the industry that lie ahead.

The single voice representing healthcare on President-elect Donald Trump’s “strategic and policy” forum belongs to Delos “Toby” Cosgrove, MD, president and CEO of the Cleveland Clinic.

Although details about what the group will discuss in its monthly in-person meetings are not yet known, Cosgrove says he’s honored by the selection and humbled that he will be able to represent healthcare to the president.

Forum members are charged with offering insights on how government policy impacts economic growth, job creation and productivity. The 19-member group will bring together leaders from business, finance, and technology and is scheduled to start its meetings in February, after the inauguration.

Following is a lightly edited transcript of a conversation between Cosgrove and HealthLeaders Media on his thoughts about the group and its purpose.

Catholic Health Initiatives pulls out of insurance business

http://www.fiercehealthcare.com/healthcare/catholic-health-initiatives-pulls-out-insurance-business?utm_medium=nl&utm_source=internal&mkt_tok=eyJpIjoiTmprM1ptSXlNVEE0WWpCaCIsInQiOiJJd24rWE1HUTl5THZuZTRuaHJMOVViMlI2MFJwcSs4Q0hyaXFlcVJHc2J5WWhucGdmVkRQem9jM1dcL2NrVitKQStmdFZSeXVvMkp1S21qNWE4bHVcLzB6akJCOVAxRzROV2JcL3ZNbFFveVI5R2owbGRHdncwemtOWUpaaG8xVHhXMyJ9

Executive looking out window

As more hospitals across the country consider launching their own health insurance plans, one big hospital operator is pulling out of the business.

Catholic Health Initiatives (CHI), a large nonprofit health system based in Colorado, no longer plans to develop a “wholly owned and nationally driven” insurance business, according to The Wall Street Journal. Instead, it’s going to sell portions of the health insurance business.

The provider, which operates 103 hospitals in 18 states, lost nearly $110 million during the last fiscal year, according to the article.

Dean Swindle, chief financial officer and president of its enterprise business lines for CHI, didn’t agree to an interview for the latest news,  but told the publication in April that “it’s tough in the health plan business. You lose money. You make mistakes. You plow forward. It takes cash.”

Partners HealthCare suffers $108M in operating losses in FY 2016

http://www.healthcaredive.com/news/partners-healthcare-suffers-108m-in-operating-losses-in-fy-2016/432128/

Dive Brief:

  • Operating revenues at Boston-based Partners HealthCare increased 7% from the previous year to $12.5 billion, but $12.6 billion in operating expenses canceled out those gains, according to the health system’s financial statements.
  • The operating loss is the largest posted in the system’s 22-years of history, which has struggled financially since it acquired Neighborhood Health Plan in 2012, a Medicaid managed care subsidiary that had a $89-million operating loss two years ago.
  • A nursing strike and implementation of a new EHR system also contributed to poor financial performance at Partners in fiscal year 2016, according to the Boston Herald.

Why Catholic Health is bowing out of the insurance field

http://www.healthcaredive.com/news/why-catholic-health-is-bowing-out-of-the-insurance-field/421923/

Dive Brief:

  • Tired of steep losses, Catholic Health Initiatives is looking to sell its health plan subsidiary, Modern Healthcare reported.
  • QualChoice Health, previously known as Prominence Health, sells Medicare Advantage and commercial plans to employers in six states.
  • CHI began buying up health plans three years ago as a way to adhere to the Affordable Care Act and compete with other carriers.