Health Care Council panelist: 'Creative structures are winning the day'

Industry flux leading players to change M&A approaches
May 6, 2015 2:12 PM

LHC in DC: The role of health care in upcoming federal, state races

The 100-strong Leadership Health Care delegation to Washington, D.C., enjoyed a keynote address by David Wasserman, House editor of The Cook Political Report. Wasserman offered a dynamic analysis of the road to the White House in 2016. In this video, he names his picks for presidential candidates and outlines the role of health care in both federal and state races.

Founded in 1984, The Cook Political Report provides analyses of presidential, U.S. Senate, U.S. House and gubernatorial races. Wasserman served as an analyst for the NBC News Election Night Decision Desk in 2012, 2010 and 2008, and has appeared on NBC Nightly News, ABC World News, C-SPAN Washington Journal, CNN and NPR.

 
Photo by Keith Mellnick

Mar 13, 2015 7:23 AM

LHC in DC: The need to clean up laws and free up data

Editor's note: This is the second post from the Nashville Health Care Council's 2015 Leadership Health Care Delegation to Washington. Look for more content from the trip in coming days and click here for entries from past visits.

 
During the second day of Leadership Health Care’s annual trip to Washington, D.C., 100 of Nashville’s emerging health care leaders heard from members of the Tennessee delegation to Congress, as well as key members of the Obama Administration, about the health care topics that are shaping policy discussions in the nation’s capital.

Sen. Lamar Alexander (R-TN) and Sen. Bob Corker (R-TN) kicked off the day’s sessions. Alexander discussed his work as chairman of the Senate committee on Health, Education, Labor and Pensions, including trying to find ways to shorten the time and cost associated with bringing a new medical treatment, pharmaceutical or device from the discovery and development phase to the physician’s office or medicine cabinet.

Corker discussed work with U.S. Department of Health & Human Services Secretary Burwell on a long-term fix to Disproportionate Hospital Share payments for Tennessee, which is the only state that doesn’t have a permanent DSH solution.

And Rep. Jim Cooper (D-TN) (pictured) delivered a talk on fraud and waste in the health care system, providing an overview of the laws — such as the False Claims Act whistleblower protection and the Stark law’s anti-kickback statute — that are intended to eliminate costly fraud but can actually create more problems than they solve.

“If we cleaned up the laws, there would be less fraud, but also the government would be saving a whole lot more money,” Cooper said. “And that’s my goal, to save money.”

LHC members also heard from Meena Seshamani, M.D., director of HHS’ Office of Health Reform and Karen B. DeSalvo, M.D., National Coordinator for HIT and Acting Assistant Secretary of HHS, about topics surrounding the implementation of the Affordable Care Act and health information technology initiatives.

Seshamani (pictured at left) provided an overview of consumerism in the health insurance marketplaces, discussing the successes of the most recent health insurance open enrollment period and the ongoing work to reach new enrollees to encourage use of those plans. She talked about her office’s desire to work with states that are interested in expanding Medicaid, noting that $4.2 billion of the $5.7 billion of uncompensated care costs that were eliminated because of the expansion of insurance coverage came in states that expanded Medicaid. And she outlined steps being taken to reform the health care delivery system, including incentives to reward value over volume, initiatives encouraging providers to deliver better coordinated care and improving the distribution of information so providers can make better care decisions.

On the health IT front, DeSalvo discussed the activities of the Office of the National Coordinator for Health IT in advancing the interoperability and usability of health data so providers can more easily share patient health data and use the information to provide better care, reduce costs, improve population health and advance scientific initiatives like precision medicine.

The key ingredients to achieving interoperability are to “standardize the standards,” create incentives to use the standards, and to create a “trust environment” where providers and consumers understand expectations around security and privacy.

“I feel really strongly that we need to unlock this data,” DeSalvo (pictured at right) said, noting that consumers know the data is useful and are frustrated that they have to keep filling out forms on a clipboard at their doctors’ offices and can’t get their children’s immunization records when they’re trying to sign up for school.

“We know the data is there,” she said. “We just have to find a way to get the data to move.”

 
Photos: Keith Mellnick

Mar 11, 2015 7:43 AM

LHC in DC: Supreme Court case front and center on first day of delegation

Editor's note: This is the first post from the Nashville Health Care Council's 2015 Leadership Health Care Delegation to Washington. Look for more content from the trip in coming days and click here for entries from past visits.

 
Less than a week after the Supreme Court heard oral arguments in the controversial King v. Burwell case, 100 of Nashville’s emerging health care leaders visited Washington, D.C., to gather insight into the policy and politics that will shape the health care industry in the year ahead. A slate of expert speakers told attendees of the 13th Annual Leadership Health Care Delegation that Washington is holding its breath as it awaits the court’s ruling, which could eliminate health insurance subsidies for about eight million Americans.

“Everyone is waiting on Secretary Burwell, and I don’t think anybody (in Washington) has a really clear idea of how they’re going to move forward, what the next play is, until they get a ruling on that case,” said CNN Investigative Correspondent Chris Frates (pictured at left), who kicked off the delegation’s two days of sessions with a briefing on the state of affairs in Washington.

Former U.S. Senate Majority Leader Tom Daschle said there’s a general consensus in Congress that something must be done to assist the millions of Americans who would lose their insurance subsidies if the court decides in favor of the petitioners in the case.

Daschle asserted that, while there are areas for bipartisan support on issues like precision medicine, telehealth and the Sustainability Growth Rate (SGR) reform, Congress remains divided on issues related to the ACA.

Anne Filipic, president of Enroll America, echoed other comments about the significance of King v. Burwell, saying there’s “absolutely no way” the eight million people who may lose benefits will be guaranteed the same level of coverage if the court decision comes down against subsidies. As part of a panel discussion on what’s next for the implementation of the Affordable Care Act, Filipic (pictured at right) and her co-panelists said a Supreme Court ruling against subsidies would be devastating for many Americans — particularly since the primary reason most Americans who remain uninsured have not purchased coverage is they assume they can’t afford it.

Of course, as the nation learned with the 2012 Supreme Court decision striking down the ACA provision requiring state Medicaid expansions, most people trying to predict the outcome of King v. Burwell are not constitutional scholars, said panelist Cheryl Jaegar, principal with Williams & Jensen and longtime former staff member for Republican leaders in the House of Representatives. It’s difficult to predict what will happen or how the industry will have to react.

Looking ahead, the panel discussed the possibility of Medicaid expansion in additional states. Mary Grealy, president of the Healthcare Leadership Council, said she could see more states expanding if their Republican governors can find a “Republican way to do it” and the federal government is willing to work with them on waivers.

The first day’s sessions also included discussion of the future of value-based purchasing initiatives, how to continue supporting providers as they work toward achieving meaningful use of electronic health records, the nature of political discussions around fixing the SGR, and of course, the 2016 general election.

Frates, who provided delegates a primer on recent happenings (or lack thereof) in Congress, said he doesn’t see a clear challenger for Hillary Clinton for the Democratic nomination. For Republicans, he thinks timing is an important factor for whoever emerges from the field, given how party favorites like Chris Christie and Marco Rubio have ascended and fallen.

Of course, it could just be a throwback year: “If you have 1992 yard signs, you might want to dust them off: Clinton v. Bush,” Frates said.

 

Former U.S. Senate Majority Leader Tom Daschle, right, talks to Dick Cowart, chair of the health law and public policy department at Baker Donelson, about King v. Burwell and other Washington topics affecting health care.

Photos: Keith Mellnick

Mar 10, 2015 7:13 AM

State uninsured rate drops 25 percent

A study released by the University of Tennessee Monday found that Tennessee's uninsured population has decreased by 25 percent from last year, marking the lowest percentage of uninsured Tennesseans in a decade.

The report found that 7.2 percent of Tennessee's 6.5 million residents are uninsured. The state has also seen a 35 percent decrease in the number of uninsured children.

The uninsured rate was helped by the establishment of the health insurance marketplace through the Affordable Care Act, the report said. The national conversation around health reform encouraged many uninsured people to evaluate their eligibility for Medicaid or federal subsidies to obtain insurance through the marketplace. Last year, TennCare experienced the third-highest new enrollment in its 20-year history.

The study also found that 93 percent of TennCare recipients were satisfied with the program. That number stands in stark opposition to a stance held by three legal advocacy groups that sued the state in federal court this summer over the agency's alleged inefficiencies.

For uninsured Tennesseans, the report found that the reason residents fail to obtain insurance is still the same — cost and affordability.

"The major reason that people continue to report being uninsured is their perception that they cannot afford insurance," the study said. A significant change in this year's results was that 12 percent of respondents said they did not obtain insurance because they did not need it, which is more than double the percentage from 2013.

It is unclear what impact this study might have on the possibility of Medicaid expansion in the state. Tennessee has so far declined federal funding to expand coverage and the Republican-controlled legislature remains opposed. Gov. Bill Haslam has said he continues to work with the feds to develop a plan and some of the state's health system execs have put Tennessee in the "maybe" camp for expansion. But a declining uninsured rate sans expansion might give opponents a little more influence in arguing against the funding.

For the full report, click here.

Nov 17, 2014 12:54 PM

CHS CEO talks politics on election day earnings call

Smith: Republicans 'have to compromise'
Nov 4, 2014 1:00 PM

CMS actuaries see health care spending growth rising again

The increase in aggregate spending on health care in the United States has slowed in recent years but the good people at the Centers for Medicare and Medicaid Services' Office of the Actuary don't see that happy tale lasting any longer. They are projecting that health care costs will rise 5.7 percent annually through 2023, easily outpacing inflation. Somewhat ironically, some of the important contributors to that growth are outgrowths of positive changes being implemented now.

An added reason taken into consideration is the expectation that more people will be taking drugs. Some will be taking drugs because the costs will be covered under the PPACA's coverage expansions. A further expectation is that enrollees and Medicare beneficiaries will be advised to take medications earlier in the course of their illness, either for prevention or treatment.

Sep 5, 2014 6:42 AM

The case for structural competency

Doctors should get beyond the clinic walls [From our Healthier magazine out now]
Jun 30, 2014 10:00 PM

Better health for those outside the system

Minor interventions yield major improvements [From our Healthier magazine out now]
Jun 26, 2014 10:00 PM

'Probably stumbling in the right direction'

Experts discuss health care value, transparency and the coming big shift in insurance
Jun 10, 2014 6:08 AM