In our final post of the series, we’ll cover the implications of the SCOTUS decision on health care industry sectors, including providers and service providers. 

Providers – Hospitals

Lynn suggested that the panelists start with the hospital industry first. Mark said that he thinks this is a segmented analysis also. For those systems that have already resolved to take steps to deal with value-based purchasing and accountable care environments with their governmental and commercial customers, the SCOTUS decision is likely to be seen as affirming the activities of their boards to date and their initial efforts. For individual hospitals that have not yet designed a strategic plan with value-based purchasing and other accountable-based assumptions baked into that plan, the decision is likely to propel them to get to work in designing such a plan. 


Continue Reading SCOTUS Decision on the PPACA – Implications for Healthcare Industry Sectors Part II

Our series recapping the Epstein Becker & Green webinar on the Supreme Court’s Decision regarding Obamacare continues! Today, we’ll be talking about the impact of the upcoming election on the plan, as well as the implications for employers. 

Impact of the Upcoming Election

Lynn asked the panelists to comment on the Presidential election and the swing states, saying that there wasn’t even agreement among the panelists as to which states are the swing states. Bill agreed, and said that both political parties count different states as swing states. He thinks that the six states that both parties agree on as swing states are Colorado, Nevada, Florida, Ohio, Virginia and Pennsylvania. 

Some Republicans think other swing states include Iowa, Wisconsin, and New Hampshire, while Democrats think Arizona and North Carolina are swing states. Bill said that if you look at the six, and you look at what the various parties and independent organizations are doing, they’ve centered on these states, and that’s where almost all of the money is currently being spent. 


Continue Reading SCOTUS Decision on the PPACA – Impact of the Upcoming Election & Implications for Employers

Last week, we talked about the implications of the Supreme Court’s decision for the states. Today, we’ll look at the potential Congressional response.

Lynn began by suggesting the panelists speak about the federal level, as she’s cynical about the 90% and 100% matching, when we’re going into a period of austerity. She said she would like them to talk about entitlement reform and deficit reduction, and asked whether the decision to expand Medicaid has a lot to do with people’s confidences that the 100% and 90% matching money will remain the law of the land at the federal level.  


Continue Reading SCOTUS Decision on the PPACA – Potential Congressional Response

Following Doug’s comments on the case for payment and delivery reform in the United States, Stuart Gerson was next to the podium to discuss whether the mandate is constitutional. 

Stuart began by saying that it’s important to understand one thing – this discussion, besides the quality and efficiency issues, is about health insurance and not about healthcare itself. This is one of the real pitfalls of the US system – we provide healthcare to almost everyone, but it’s done through a series of cost-shifting and inefficiencies, and that’s what these programs are trying to address. 

He added that he hoped to make his presentation interesting for non-Americans, many of whom live in systems with national health programs supplemented by private insurance. These countries feel that they have all the answers, and in some senses they do, with many of the countries providing a reasonable quality of healthcare at a vastly lower percentage of the GDP than what the US is doing. Although the US has some high end medicine, we also have a lot of inefficiency. 


Continue Reading Is the Mandate Constitutional – US National Health Care Act – a Presentation by Stuart Gerson

Rumor has it that SCOTUS might announce their decision on the PPACA today, so there’s no more appropriate time to continue our discussion of health care reform! Today, I’m bringing you a recap of Doug Hasting’s presentation during the ILN’s 24th Annual Meeting in Washington, DC. 

Doug said he would touch a little bit on the context that the health reform law provides or relates to in connection with the way that the healthcare delivery system in the US is evolving. He said that there are interesting interconnections there that lead into implications for how the Supreme Court ruling, whichever way it comes down, might affect that system. 

The healthcare delivery system – doctors, hospitals, long-term healthcare companies, laboratories – in the US is overwhelmingly private. There is a little bit of veterans’ care, and some state universities have partial relationships with university medical centers, but otherwise, it’s overwhelmingly private. From a payment standpoint, it’s about 50% private, but when you add in all of the different components of Federal and state payment (Medicare, Medicaid, etc.), there is still a significant amount of private health plans paying for healthcare. 


Continue Reading The Case for Payment and Delivery Reform in the US – A Presentation from Doug Hastings