Health-care reform effects serious change

By Frank Gluck
Even if the Supreme Court rules against the law, the industry will be different.
Whatever the outcome of a U.S. Supreme Court review of the health reform law next year, 2011 ends with the legislation transforming the local health care industry.
Financial incentives and penalties written into the law, and now coming into effect, are a reason for the changes.
Another: Doctors and hospitals likely will see continuing cuts to Medicare and Medicaid, insurance plans that account for majority of patients in Lee and Collier counties.
“We’re going to be paid for outcomes, not what we do,” said Dr. Allen Weiss, CEO of the NCH Healthcare System in Collier County. “We can’t afford to compete with the amount of money we’re spending and the value we’re getting out of health care.”
Besides, health care organizations have considerable skin in the game.
Southwest Florida’s hospital systems and physician practices are buying costly government-encouraged electronic record systems – a $70 million investment in Lee Memorial Health System’s case – to improve efficiency and head off coming Medicare penalties if they don’t.
They also are expanding low-fee community health clinics, thanks in part to government grants, to help reduce unnecessary emergency room visits.
New initiatives
Other new initiatives, such as costly post-hospital home care and tele-medicine programs, are aimed to reduce hospital re-admissions. Again, they face Medicare cuts if rates are too high.
Lee Memorial, the region’s largest hospital organization, also is working to expand its behavioral health and home-care programs with help of federal health reform-related grants.
“Even if reform in its formal sense gets shot down, the reality is, as a nation and as a state, we can’t continue to finance health care the way we’ve been doing it,” said Jim Nathan, president of the health system. “By simply cutting back on reimbursements, changes will occur. And some of the (health reform) elements in place are actually some good elements.”
More than 256,000 Florida seniors falling into Medicare’s prescription drug coverage gap – the so-called “doughnut hole” – have seen the cost of their medications drop as much as 40 percent since 2010, a result of health reform politicians may be loathe to scrap.
1 2 3 4 Next