Hospitals seek more collaboration as Obamacare continues to roll out

“No person turned away” breaking hospitals’ banks

BY KATHY KAHN

How are hospitals faring under the Affordable Care Act?

Steven Kroll, vice president for governmental affairs for the Hospital Association of New York State (HANYS) on Thursday spoke with members of the Rockland Business Association at the Pearl River Hilton on the changes taking place within New York’s hospital system as a result of Obamacare.

“Private physician groups, unlike hospitals, have the option of turning away people without insurance—they can also get things done faster than a hospital can when it comes to introducing new services…we are bound to strict regulatory procedures—and we have take care of everyone who comes in our door,” said Kroll. “As a result of the changes to reimbursements, hospitals have been tasked to achieve better outcomes with lower costs and to create more extensive collaboration between hospitals and all entities that play a part in the patient’s care.”

To that end, to help hospitals stay competitive with for-profit physician practices offering “one stop healthcare shopping,” the growth of Accountable Care Organizations across the country—wherein hospitals partner staff and services, becoming interdependent upon each other and offering the same services as that of their private counterparts– is growing in popularity. “The coordination of care results in better outcomes for patients and cost savings for the hospitals,” said Kroll. “Nyack Hospital’s affiliation with New York Presbyterian Healthcare System is just one example of a successful collaboration.” (Helen Hayes Hospital in Haverstraw is also part of NYPHCS.)

“Everyone wants to pay less for healthcare, and people want the best but also want to pay the least amount they can. Right now, our hospitals are reimbursed 98 cents on the dollar by Medicare and 76 cents on the dollar by Medicaid. Those figures are not going up. The challenge is to transform the way we deliver services without losing quality within that payment framework.”

Something that could help boost New York’s outcomes and financial fragility would be a forged agreement between the federal government and New York’s Medicaid/Medicare Redesign Team that’s currently awaiting approval.

Gov. Andrew Cuomo announced New York had reached an agreement in principal with the feds on a Medicaid Redesign Team (MRT) waiver. It will allow the state to reinvest $8 billion in federal savings generated by MRT over five years to help hospitals transition into healthcare systems. “We hope to have a final decision on this soon,” said Kroll.

Kroll said it was vitally important to get as many New Yorkers signed up on ACA, particularly its Millennials, (25-34 age group) who traditionally bypass health insurance. “They’re young and healthy, so they don’t think they need it, but by signing on, they are guaranteeing they are protected –no one is invulnerable to a health crisis—and helping to pay for the program for all New Yorkers.”

Obamacare has hit many bumps in the road—from a mediocre rollout of the program with a multi-million website with a multitude of miscues and states overwhelmed by applications they cannot process quickly enough. There are also concerns it will leave currently insured employees without insurance, since many companies are dropping their own healthcare programs and encouraging employees to buy healthcare through the exchange system.

To date, New York has taken in over 745,000 completed applications and gotten 456,000 people enrolled. In the meantime, those who are undocumented aliens will continue to use their local emergency room for healthcare, while thousands of others will slip through the cracks, making too much to qualify for Medicaid but not enough to pay for healthcare. “I thought Obamacare was going to help cover everyone,” said one RBA member after the presentation. “I’m still trying to come to terms with how I am going to pay $25,000 a year for my family under the new law…it doesn’t seem ‘affordable’ at all.”