#2 Preparing for Health Care Reform
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Transcript of #2 Preparing for Health Care Reform
The Mississippi Hospital Association
Preparing for Healthcare Reform
September 30, 2010Hilton Hotel
Jackson, Mississippi
The Mississippi Hospital Association
Leaders Speak UpA Panel Discussion
Dinetia NewmanBalch & Bingham LLP
September 30, 2010Hilton Hotel
Jackson, Mississippi
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HEALTH CARE
REFORM
Integration
Quality
Capacity
Patient Safety
CRITICAL COMPONENTS OF HEALTH CARE REFORM
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Comments From Panel Members
(In Alphabetical Order)
• Gary Marchand
• Rick Napper
• Wallace Strickland
• Gerald D. Wages
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CRITICAL COMPONENT OF HEALTH REFORM - QUALITY
• ACCOUNTABLE CARE ACT MENTIONS “QUALITY” 563 TIMES
• TITLE I—QUALITY, AFFORDABLE HEALTH CARE FOR ALL AMERICANS
• TITLE III—IMPROVING THE QUALITY AND EFFICIENCY OF HEALTH CARE
– Subtitle F—Health Care Quality Improvements
• TITLE X – STRENGTHENING QUALITY, AFFORDABLE HEALTH CARE
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CRITICAL COMPONENT OF HEALTH REFORM - QUALITY• Health Reform Focuses:
– Readmissions– Post Acute Care Bundling– Hospital Acquired Conditions– Value Based Purchasing – Quality Reporting Requirements– Accountable Care Organizations– Patient-Centered Medical Homes
• Consequences of Failure to Improve Quality• Steps to Take to Achieve Better Quality• Impact of EHR on quality
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CRITICAL COMPONENT OF HEALTH REFORM – PATIENT SAFETY• Accountable Care Act mentions “safety” 93 times• Quality and Patient Safety work hand-in-hand• Same focus as with quality• Example:
– h) QUALITY IMPROVEMENT.(1) ENHANCING PATIENT SAFETY. Beginning on January 1, 2015, a qualified health plan may contract with (A) a hospital with greater than 50 beds only if such hospital — (i) utilizes a patient safety evaluation system as described in part C of title IX of the Public Health Service Act; and(ii) implements a mechanism to ensure that each patient receives a comprehensive program for hospital discharge that includes patient-centered education and counseling, comprehensive discharge planning, and post discharge reinforcement by an appropriate health care professional…
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CRITICAL COMPONENT OF HEALTH REFORM – CAPACITY AND ACCESS• Title I, Subtitle G, § 1554 – Access to Therapies• Title II, Subtitle A—Improved Access to Medicaid• Title III, Subtitle B, Part 1- Beneficiary Access to
Physician Care and Other Services• Title IV, Subtitle B - Increasing Access to Clinical
Preventive Services • Title V, Subtitle F, § 5501 – Expanding Access to Primary
Care Services and General Surgery Services• Title V, Subtitle G – Improving Access to Health Care
Services• Title VI – Improving Access to Innovative Medical
Therapies
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CRITICAL COMPONENT OF HEALTH REFORM – CAPACITY AND ACCESS
• Hospital capacity to provide access for current and new insureds to physician and non-physician practitioners
• Hospital capacity to offer access to technology and other resources
• Entitlement expectation• Impact of Independent Payment Advisory Board
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CRITICAL COMPONENT OF HEALTH REFORM – INTEGRATION
• The Washington Post - As more hospital systems consolidate, experts say health-care prices will jump – By Julie Appleby - Kaiser Health News
Saturday, September 25, 2010; 6:20 PM – From their base in Baltimore, leaders of Johns Hopkins Medicine can see
the future - and it's at the hospital down the road.
• BNET: Healthcare Reform Drives Physicians Towards M&A and
Hospital Buyouts- By Arlene Weintraub - June 14, 2010 • Becker’s Hospital Review - The Impact of Healthcare Reform on
Hospital Consolidation - Written by Leigh Page | September 16, 2010
• Irving Levin Associates – Information on M & A, Finance, Healthcare and Seniors Housing - Health Care M&A Accelerates In Second Quarter After Passage of Reform According to New Report by Irving Levin Associates, Inc
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CRITICAL COMPONENT OF HEALTH REFORM – INTEGRATION• Drivers
– Quality initiatives– Value-based purchasing– Medicare and Medicaid payment reductions for
hospitals (and physicians)– New Delivery Systems– Workforce (or lack of it) changes
– Physician concerns– Technology costs– Workforce costs – Insureds expectations
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THANK YOU!!!
Gerald D. WagesNorth Mississippi Medical Center830 South Gloster StreetTupelo, MS 38801
Gary G. MarchandGulfport Memorial Hospital4500 Thirteenth StreetGulfport, MS 39501
Wallace StricklandRush Health Systems, Inc.1314 19th AvenueMeridian, MS 39301
Dinetia M. NewmanBalch & Bingham, LLP401 East Capital Street, Suite 200Jackson, MS [email protected]
Ricky D. NapperMagnolia Regional Health Center611 Alcorn DriveCorinth, MS 38834
The Mississippi Hospital Association
Preparing for Healthcare Reform
September 30, 2010Hilton Hotel
Jackson, Mississippi