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Obamacare won’t change the way faith-based hospitals in Alabama deliver care, leaders saycomment (0)

August 28, 2014

By Carrie Brown McWhorter

Obamacare won’t change the way faith-based hospitals in Alabama deliver care, leaders say

Faith-based health care providers in Alabama say it is too soon to know how the Affordable Care Act (ACA) will affect their patients, but they insist that any changes will not interfere with their mission to provide quality and timely Christ-centered medical care.

Though more than half of Americans still view the law unfavorably, the ACA — also known as Obamacare — is now the law. While almost everyone agrees the 3,000-page law passed by Congress and signed by President Barack Obama in 2010 is far from perfect, health care providers don’t have the luxury of watching all the wrangling from the sidelines. 

Peter Selman, CEO of Baptist Medical Center South in Montgomery, sees potential benefits for patients if the law corrects the worst problems of the old model of health care, a system he called “unsustainable.”

Positive changes

“The status quo was very broken. Our nation’s health care system is inefficient, inconsistent, fragmented and unaffordable for most Americans. Change was necessary,” Selman said.

One of the positive changes Selman sees happening as a result of the ACA is an increased focus on wellness. In the past, hospitals were rewarded for having beds filled with sick people, he said. Now the focus has shifted to preventing and managing diseases. 

“We are focused on transforming our organization away from a ‘fee for service’ model to a model that provides incentives to manage the health of all citizens in our region,” Selman said.  

The ACA’s goal of providing access to health insurance for more Americans has potential benefits as well, Selman said.

“The law has successfully enabled millions of the estimated 50 million uninsured Americans to get health care coverage,” he said. “Having health care insurance does not always equate to seamless health care access, but it is an important first step.”

Hugh Greene, CEO of Baptist Health in Jacksonville, Fla., said in a 2013 presentation that spiraling costs and increasing numbers of uninsured patients have been driving the need for health care reform for several years. Still the bill in its current form has many flaws, he said. For example, malpractice reform, a huge factor driving up costs of health care, did not make it into the law for political reasons. 

In addition, the Supreme Court decision allowing states to refuse federal funds for Medicaid expansion has hurt hospitals, Greene said. Under the ACA, hospitals voluntarily took a cut in the amount they are reimbursed by Medicare, thinking the increase in newly insured patients from Medicaid expansion would more than make up the difference, Greene said. 

Early reports indicate hospitals are getting a stronger-than-expected benefit from a new influx of low-income patients whose bills are paid by the government’s Medicaid program. Nashville-based HCA Holdings, Inc., the nation’s largest for-profit hospital chain, reported a 6.6 percent drop in uninsured patients at its 165 hospitals. In four states that expanded Medicaid, the reduction grows to 48 percent.

However, a number of states, including Alabama, refused to accept the increased federal funds for Medicaid. As a result some patients in Alabama have lost their prior insurance coverage and many others are still doing without, said Greg Johnston, senior vice president and CFO of Baptist Health System (BHS) in Birmingham. 

“The intent of the ACA is to lower the number of uninsured by expanding Medicaid and increasing commercial insurance coverage by providing subsidies on the health insurance exchange. However, without expanded Medicaid the number of uninsured patients has remained the same — actually increased slightly — and those now covered on the exchange were previously covered by individual policies or some other private plan,” he said.

“So we’re not seeing more insured patients and we’re being paid less for our Medicare patients,” Johnston said. 

Another major problem is higher costs to patients, a problem BHS is trying to mediate.

“As a hospital system, one greater role we’re playing with our patients deals with the patient’s insurance coverage. Under ACA, most plans now require higher out-of-pocket payments for co-pays and deductibles, so we’re now providing more education and working with patients as they pay a higher share of the reimbursement,” Johnston said.

Despite the challenges, both Selman and Johnston say their hospitals and providers are committed to working within the law to deliver quality patient care in a Christ-centered manner.

Leadership role

Selman said, “As the largest health care system in central Alabama, Baptist Health enthusiastically embraces the leadership role in reforming health care. We are well-positioned to meet these challenges and we expect our communities to look to us to be the captain of this ship.”

Johnston said, “The ACA aside, we believe the future in health care comes down to greater coordination of care. As such, we have invested resources, and our physicians are investing time and resources, to create an integrated health delivery system to provide the highest level of care as efficiently and as cost-effectively as possible.”

(ABP contributed)

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