It finally happened, Republicans of Congress put a piece of legislation on the floor of the House that would overturn the major provisions of the Affordable Care Act Not only did the American Health Care Act (AHCA) vote, but it voted in Narrow vote of 217-213 .
Some of the key points of discussion for the bill are that it would cut off Medicaid's expansion efforts and remove individual and employer mandates that will likely impact the numbers of people covered and ask for care services (if coverage or not). The CBO did not note the revised version of the bill, but the original score revealed that 24 million more Americans would be uninsured in the next 10 years, while saving $ 337 billion in deficits federal budgets.
The bill will now move to the Senate, although the path to America without ACA could be difficult since the upper house has already stated that it would draft its own version of a draft bill. Act repealing the ACA. Since health care is a $ 3 trillion industry, there will be no overnight reform. Given the timing, there is a lot of uncertainty to convey about the AHCA and its effects. Many consumers are concerned that the bill will escalate their costs of care due to pre-existing conditions. There is also a question about how the "pre-existing condition" will be defined. Insurers are concerned about cost-sharing payments and hospitals may lose revenue sources if patients delay or abandon their care.
"We see hospitals, payers and doctors uniting with one voice, which is frankly unprecedented," said Delphine O. Rourke, Managing Partner at Hall, Render , Killian, Heath and Lyman, Friday at Healthcare Dive. "Usually, they negotiate from different positions.When we look at the winners and losers [with the AHCA] hospitals, doctors and insurers will be the losers both with the House bill and something similar. "
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O & # 39; Rourke shared his thoughts on what the current version of AHCA means for hospitals and how systems should think about their financial future. O & # 39; Rourke's comments have been slightly modified for clarity and length.
When adopted as is, hospitals will see a decrease in patient volumes – which is already the case
The ACA resulted in a significant drop in reimbursement of Medicare patients to hospitals in 2010 that have already taken effect. According to the theory, hospitals would benefit from a greater number of patients who could pay for their care and there would be an increased number of lives covered to offset the high costs of care and the cuts in health care. Medicare have already taken place.
Hospitals need to consider how to absorb the cuts in their strategic fiscal plan, alongside the reductions they are already absorbing. There is already a lower volume. If patients do not know where things are going, they are holding back and delaying care. So you can have patients who have insurance but the quality of their insurance is going to be lower. When they decide between food, education, wellness and preventive care, they will have mammograms, annual visits, and so on.
Hospitals can expect continued reductions and a decrease in the number of patients accessing services. In addition, the acuity of future patients will be sicker and more expensive to take care of or to go to emergencies. The bottom line for hospitals is to examine the financial projections. This is going to be a significant blow for hospitals, especially hospitals that have a mix of high Medicaid payers.
There will be hospitals that can not survive this. The patients who can do it are ready to go further for their care and some have to do it. Some patients will not be able to provide care. We will see a crisis in access to care. We are going to have care deserts.
There will be downstream implications affecting the services of third party suppliers
I already hear and see a significant decrease in third party services. These providers could provide surgical masks or concierge services. Overall, unless they are critical, we are seeing a decrease in demand already in purchases and requests. Technological upgrades could be delayed. You will see a downstream impact on the suppliers. From bed sheets to robotics, you see cuts. Like any business, if money does not arrive, what can you control? Your expenses You can do everything to bring patients, but if patients do not come, you will reduce your expenses.
Be conservative with financial projections. Focus on the health of the population
Hospitals that are successful in positioning themselves for the health of the population will be the ones that will survive. This is a risk management proposal. We are losing sight of these debates in order to have a better quality of delivery. Manage the population you have. Know your population Reimbursement, especially for a per capita model, will be capped per person. So, understand the lives covered and adapt the service delivery to the lives covered.
By: Jeff Byers
Photo Credit: Courtesy of HealthcareDIVE