Healthcare Reform
Like most of you, Barton Health’s CEO John Williams is taking a very active interest in Health Care Reform as it makes its way through Congress. In an effort to help keep you informed, this section of our Web site will be dedicated to updates and information regarding the Health Care Reform bills and what they mean for Barton and our community. John will continue to post updates and links as new information is available.
April 26, 2010
Health Care Reform update:
There’s still a lot we don’t know about the details of the health care reform legislation, but here’s a quick run down on a few things we do know, according to the California Health Care Foundation:
Reform gives boost to Nurse Practitioners:
The new health care reform law would expand Nurse Practitioners' power by:
- Allocating $50 million to nurse-managed health clinics providing primary care to low-income individuals
- Allotting $50 million annually from 2012 to 2015 for hospitals to train nurses with advanced degrees on how to care for Medicare beneficiaries
- Providing 10 percent Medicare bonuses to primary care providers, including Nurse Practitioners, who practice in areas with few physicians
The American Medical Association currently opposes proposals to expand Nurse Practitioners' responsibilities. The AMA and other critics say such action could put patients at risk. However, Nurse Practitioners contend they are highly trained, spend more time with patients and charge less.
Reform gives “teeth” to IRS:
The new law does not allow the IRS to impose liens or levies to collect penalties from individuals who do not have health insurance, nor does it allow the agency to audit individuals to ensure they have coverage. However, the IRS is not prevented from reducing a tax refund to collect the penalty.
Consumer group calls for more regulation of insurance rates:
The advocacy group, Consumer Watchdog, sent a letter last week to the Obama administration and Congress contending that the new health care reform law missed an opportunity to limit how much insurers can charge for coverage. Consumer Watchdog said the new law calls for Health & Human Services (HHS) to examine "unjustified rates," but it does not define when a rate increase can be categorized as "unjustified." Consumer Watchdog called for lawmakers to address potential loopholes in the reform law. The group recommended:
- Requiring insurers to seek prior approval for rate hikes
- Prohibiting insurers from rescinding coverage after a member becomes ill
- Providing Medicare with greater authority to negotiate prescription drug costs.
Experts say it is unlikely that Congress will pursue any major changes to the reform law in the near future. However, the California Legislature currently is considering a proposal that would require insurers to seek prior approval before instituting rate hikes. Premium increases have been a major issue in California since Anthem Blue Cross of California informed about 800,000 individual policyholders that their premiums would increase by as much as 39 percent.
April 16, 2010
Health Care Reform Impacts on Local Health Care
John Williams, CEO Barton Health
How is America’s health care reform going to affect the health care marketplace? That’s the big question being asked by hundreds of health care providers across the nation just like Barton Health.
According to the California Hospital Association, there are currently 54 million Americans - including 7 million Californians - who are without health care coverage. As a non-profit health care provider, Barton Memorial Hospital is dedicated to treating everyone who comes in the door, regardless of their ability to pay. Our goal is to provide high quality care for everyone by offering affordable, medically necessary care consistently in all of our facilities.
However, with the uninsured population steadily on the rise, coupled with Medicaid policy changes, cutbacks in public and other subsidies, and a downturn in the number of fulltime residents and visiting tourists, health care for Lake Tahoe has been on rocky ground for the past year.
This unfortunate trend is expected to continue through 2011. Failure to support the local providers could cause our health system to dwindle in services offered, significantly impacting uninsured people and our entire community.
Take a moment to imagine South Lake Tahoe without services like an Emergency Department to treat unexpected, life-threatening conditions or a Family Birthing Center to attend to delivering moms and their newborns. Picture our community without the Barton Community Clinic which sees thousands of uninsured and underinsured patients each year. Would employers be able to recruit qualified candidates for positions if a solid health care foundation was not in town?
Discounted health programs like Wellness Lab Draws, discounted EKGs, free health screening and H1N1 vaccination clinics would no longer be available. Patients would be required to travel significant distances for all their health care needs. Barton would not be here to provide financial assistance to help pay for medical care for those who cannot afford medical coverage.
When painted, the health care picture in South Lake Tahoe without a local community hospital is bleak. Unfortunately, the current reform is not going to strengthen the position of our health care providers. In fact, most hospitals may still see a larger financial hit with further deterioration in their balance sheets. Budget cuts to California’s Medi-Cal program in 2009 have put patients and our hospitals at even greater risk.
Already in the works are further decreases in reimbursements for Medicare and more than likely Medi-Cal. The new Medi-Cal reimbursement cuts are further eroding an already under-funded program. Medi-Cal ranks last in the nation in payments to health care providers. California’s community hospitals lost $2.8 billion in 2007 from inadequate payments for care provided to Medi-Cal patients and that loss continues to climb.
Adding to the financial strain, the current federal budget calls for payment delays to doctors and hospitals. For some hospitals, such delays meant laying off health care workers, suspending services and perhaps closing altogether. Barton Health has been forced to look at cost containment including some cuts to employee benefits, layoffs and consolidation of services. These fiscal measures were necessary to ensure that Barton Health continues to function as a viable, competitive health care provider offering the highest level of quality care possible and employment for 925 community members.
Health care reform is needed to help broaden the reach of access to medical services for all Americans. At Barton, we are dedicated to working with the current reform bill for the benefit of our community and our hospital. We plan to consistently look at our services and streamline where there are opportunities, in an effort to survive the volatile climate of health care in our country and provide comprehensive services to our community. We will continue to seek grants and take advantage of rural health benefits, so that we can continue our dedication to enhancing performance and customer service, continue to recruit highly-trained physicians and purchase the latest technology.
John Williams is the Chief Executive Officer at Barton Health. He is also on the Board of Directors of the Hospital Council of Northern and Central California.