And just like that, we’re halfway through August! I hope everyone who is taking holidays this month is enjoying them, and getting ready to jump right back into the fray come September. As a kid, I loved school, so September is always my favorite month! 

Without further ado, here are this week’s top posts from

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

Yesterday, we talked about the impact of the election on the PPACA, as well as the implications of the PPACA for employers. Today, we’ll delve into the implications for healthcare industry sectors with our final post in the series. 

Lynn kicked it off by saying that before we go into each sector individually, she wanted to make an introductory comment. There are people who have asked why did the stock market reach bullish about healthcare stocks following the decision, but then not bullish about it, and whether anything can be read into this. Lynn said that whenever she reads these kinds of articles, she has to laugh, because each company is in their own relationship with entitlement programs and private health insurance, and they have different starting points and are in different states. 

She said there is the number one issue – what she calls the "elephant in the room" – which is whether the penalty is strong enough to get people to buy health insurance, in which case, you’ll have a different set of winners and losers, versus whether the penalty does not. Will employers drop people into the exchange, or will they stay self-funded and keep the insurance that they have? 


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

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

Yesterday, we talked about the overview and analysis of the SCOTUS decision about the PPACA, and today, we’ll begin with talking about the implications for the states.

Lynn said that she wanted to build off of Stuart’s point about federalism, and discuss what’s going to happen at the state level. The state is going to have to decide whether to expand its Medicaid program, whether to do an exchange or not. States, like the federal government, also have an executive and legislative branch. The ACA requires the establishment of exchanges in each state, and if a state does not do it, there will be a federal exchange. Lynn said we’ve seen movement by the Obama administration for perhaps a hybrid exchange, where the feds come in where the states need extra capabilities. 


Continue Reading PPACA – Implications for the States – A Recap

After our 2012 Annual Meeting, I recapped a session from the conference that had focused on the topic of healthcare reform (See here, here and here). Once the Supreme Court announced their decision, Epstein Becker & Green’s healthcare experts once again came out to help us understand what’s in, what’s out and what’s next with their webinar on July 2nd. 

Since it’s always good to hear from the experts, I thought I’d recap the webinar here for you, again, breaking it up into manageable bites (so to speak). 


Continue Reading Overview and Analysis of the SCOTUS PPACA Decision – A Recap

Another week has flown by here, and we’ve got some great articles for you this week – the ILN is lucky to have some of the smartest attorneys out there commenting on SCOTUS’s decision from yesterday, so be sure to check out those posts! 

Also, my sister’s wedding last weekend was absolutely beautiful. For a

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