Healthcare act forcing changes, but working

By Steve Smith - Staff Writer
Region - posted Fri., Feb. 22, 2013
U.S. Rep Joe Courtney (D-2) talks to healthcare professionals and business leaders about the changes that the 'sequester' cuts may bring to Medicare. Photos by Steve Smith.
U.S. Rep Joe Courtney (D-2) talks to healthcare professionals and business leaders about the changes that the 'sequester' cuts may bring to Medicare. Photos by Steve Smith.

U.S. Rep. Joe Courtney (D-2) spoke at the quarterly meeting of the Business Alliance for Community Health on Feb. 22, held at Manchester Memorial Hospital. Courtney gave the business leaders his take on Congress’s upcoming dealings with automatic spending cuts (being referred to as "the sequester") and how they affect things including Medicare and the healthcare industry.

“The deadlines that are staring at us in the face are so grave, in terms of our country,” Courtney said, adding that the potential cuts are like a “chainsaw” going through the federal budget, without regard to priority, affecting defense spending and non-defense spending equally. However, Courtney said the compromises across party lines he has seen lately have been encouraging.

Both Courtney and ECHN President and CEO Peter Karl said there are challenges, currently and ahead, as the healthcare industry changes over systems of operation to manage new ways of doing business within the parameters of the healthcare act.

“The real guts of this are about delivery of healthcare,” Courtney said. “The incentives that were built into the ACA are already kicking in. I think the system was ready for change. The old fee-for-service system is something I don't think even providers liked. We're now getting people working together. They are moving at mach speed toward transforming the system.”

Karl said he feels most healthcare organizations are in favor of the act, because they have felt the need for change. Largely, the transformations now are in the information technology vein, and that translates to more efficient patient care.

“The interconnectivity that's now available, because of the technology changes and the ability to get reimbursed from the government for putting in IT systems – connecting physicians to hospitals, and hospitals to other hospitals – reduces the duplication of services,” Karl said, explaining that if a patient has a CAT scan at one hospital and then is seen at another, that data is transmitted electronically, instead of necessitating a second scan.

“Because of all of these linkages, the concept is excellent, because you're going to lower utilization and lower the total cost of healthcare,” Karl said.

The other transition is the fee-for-service mechanism to one that bundles services for treatment plans.

“That makes all the sense in the world,” Karl said, “[but] it's that the infrastructure of healthcare, at this point in time, isn't strong enough to sustain all of these changes at this rapid pace. We're going to have to figure out how we can all work together to make that work. It's just the matter of getting from point A to point B.”

Courtney said a lot of the consolidation of healthcare companies and facilities is being driven by the healthcare act, and that is working well, in reducing re-admissions and emergency room visits. ECHN hospitals, including Manchester Memorial and Rockville General, are “making the grade” as far as the re-visiting rates.

The congressman said he is also opposed to the proposal of changing the Medicare eligibility age from 65 to 67, because the savings already being seen by the efficiencies in the healthcare act are much greater than what that cut would bring, and people who are 65 and 66 would feel a negative effect in their wallet.

“The economy still touches people who are retired,” Courtney said. “Those efficiencies, that are happening and identified as structural, have actually generated savings twice as much as raising the eligibility age. I think there are better ways to strengthen the finances of Medicare.”

Courtney said the healthcare act is unlikely to face any further major challenges, but like anything, is certainly susceptible to changes and adjustments.

“Like any law, it’s going to be subject to change,” Courtney said. “Medicare has been amended close to 50 times since 1963. If you look at the Affordable Care Act, it too has been amended.”

Calling it “outrageous,” Courtney said the 1099 filing requirement, which would have required employers to file a tax form when employees purchase a healthcare plan costing $500 or more, is one thing that fortunately has gone away.

“There are things that need to be looked at and fixed,” Courtney said. “As far as a full-scale repeal, the election sort of settled that issue. That's not going to happen.”

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