Has the Affordable Care Act reduced the differentiated value of services provided by Not For Profit hospitals that special tax exemptions will be eliminated? Therefore, the existence of Not For Profit hospitals will disappear and all hospitals will be considered For Profit. To appreciate how this is a real possibility, it is important to understand the purpose of a Not For Profit hospital. The purpose of a Not For Profit hospital is to serve families in the community that cannot afford medical care. In exchange for this charity care, Not For Profit hospitals receive exemption from federal and state corporate income taxes, exemption from state and local property taxes, and access to tax-exempt bond financing. In addition, charitable contributions to Not For Profit hospitals are tax deductible for the donor. This allowed Not For Profit hospitals to live up to their mission of serving the community and being financially viable.
Now that the Affordable Care Act will provide
When the Affordable Care Act was passed in 2010 the year 2014 was designed as the first year in which all Americans would have access to affordable health care. It was not envisioned that all would take advantage of the opportunity, but that opportunity would be there. The Supreme Court ruling, complexity of the law, partisan politics, and the limits of time have combined to create a different health system in 2014: one that may yield very different opportunities for coverage for very similar individuals and families.
The Supreme Court upheld the law, but somehow found that an expansion in eligibility constituted a separate program. As a result states could chose whether to expand Medicaid or keep their old Medicaid program. The irony is that states whose taxpayers, employers, and health systems would most benefit from Medicaid expansion are the most likely to have decided decline that option. Those choices were mostly in response to political considerations rather than
There is a great need for further integration of health information technology into our mental health practices across the nation. If EHRs will truly make a quality difference, behavioral health care is an area of health care that may be in the most need. An overwhelming amount of the substance abuse, chronic illness, violent acts, and suicides are related to the health of the mind. Almost everything we do in and out of healthcare is related to the health of the mind if you think about it.
In 2012, an ONC Behavioral Health Roundtable Report stated that only 20% of the surveyed behavioral health organizations had fully adopted EHR. This is in comparison to a 40% or higher rate which is often reported among the general population of health care providers.
You may have heard the stories about the US Mental Health System and how it has evolved over the years from an inpatient focused model to providing treatment in our communities. Each day in our communities we are likely to see
Since publication of the Institute of Health (IOM) report entitled “To Err is Human,” our healthcare system generally, and hospitals specifically, have tried to create, develop and nurture a culture of patient safety. The IOM reported almost 100,000 Americans lose their life each year due to preventable medical errors. In fact, according to the IOM, “More people die in a given year as a result of medical errors than from motor vehicle accidents (43,458), breast cancer (42,297), or AIDS (16,516).”
Something must be done to reduce or eliminate medical errors that could have been prevented.
The IOM report further states, “This report describes a serious concern in healthcare that, if discussed at all, is discussed only behind closed doors. As health care and the system that delivers it become more complex, the opportunities for errors abound. Correcting this will require a concerted effort by the professions, health care organizations, purchasers, consumers, regulators and
The big news of the week was the delay of the employer mandate in the Affordable Care Act, which required businesses of 50 or more employees to offer affordable health insurance for someone who works at least 30 hours a week or face an annual penalty. The Obama administration acted abruptly in its announcement to push the mandate back one year to 2015 and beyond next year’s midterm election. It was explained that businesses needed more time and clarification on the rules in order to properly comply with the new requirements (i.e., many business owners/leaders were incredibly unhappy with these provisions).
The action by the Administration does not technically postpone other central provisions of the law. Yet, it does question if other central tenets–like the health insurance marketplaces in the states–will be ready by January 1, 2014. Whether the employer mandate continues to morph from its current form or simply be delayed, it is certain that this action by the
It’s no secret that the next seven years will see a huge increase in needs for patient care, as newly insured patients come into the system in 2014, and the healthcare needs of retiring baby boomers begin to escalate. How will the job market in Georgia weather these predictions? For that matter, how will job seekers first afford higher-level education that will qualify them for these 5 million job opportunities?
As I continue to interface with healthcare organizations around the world, the same challenges exist. At varying levels, whether a Country has a Nationalized/Universal healthcare program (Japan, UK, Taiwan) a Privatized healthcare program (U.S.), or a hybrid model (Singapore), key stakeholders are all faced with addressing fundamental issues – driving down cost, making healthcare more accessible, finding ways to improve patient outcomes, and ultimately improving the quality of care for their citizens.
These past few weeks I’ve had the honor of presenting at the Connected Health Asia Conference in Singapore and to the Japan Pharmaceutical Manufacturer’s Association in Tokyo. And, a few overarching themes pervaded most of my discussions.
As the Healthcare Reform initiatives drive providers to think outside the box and evaluate new sources of revenue or integration models, the Office of Inspector General (“OIG”) last week shut down one potential proposal that many providers may have considered. Specifically, the OIG found in an Advisory Opinion that a management company assisting a provider in establishing a new service line could potentially violate the Anti-Kickback Statute and that the government could enforce penalties for such violation. The Anti-Kickback Statute generally prohibits anyone from knowingly or willfully providing any form of remuneration to another individual to induce the purchasing, ordering or referral of services that are billed to state and federal healthcare programs. Interestingly enough, in this proposal, the parties attempted to exclude state and federal beneficiaries to avoid any such violation, but the OIG took a broad approach when examining the proposed arrangement.
The preliminary numbers look like the Affordable Care Act (ACA) is going to work as intended. Insurers were required to declare if they were going to and what plans and premiums they would offer in the individual exchanges by early May. In Georgia, seven insurers are participating in all or parts of the state. The premiums and plans they are offering resemble those currently offered by large employers.
A central question is whether the private insurance market as reconfigured by the ACA will be sustainable. A sustainable private insurance market is possible only if adverse risk selection is managed. Adverse risk selection is the fact that individuals with the highest demand for health insurance are those with the greatest health care needs. No insurance market can be sustained if the only people purchasing insurance are those about to file a claim.
Currently almost 95 percent of those with private health insurance coverage purchased that coverage through an employment-based
What is” it” you ask? Healthcare Reform
The picture in Georgia appears to be pretty bleak. The State has chosen not to expand Medicaid. Early estimates predict the cost of Health Insurance on the exchanges may be 45% higher, than the ridiculously high cost Georgians are already paying for Health Insurance. Any chance of an affordable plan will likely come with a deductible of $5,000 or more. Employers are dropping coverage left and right in favor of the penalty, which in reality is not really a penalty because it is cheaper. Employers, who are opting to keep their group plans, are facing substantial premium and deductible increases, as well. It is not looking good for anyone, especially those who most need it, from a cost perspective.
However, the average member of society- the one who does not work in the industry- does not understand, and they are not ready for what lies ahead. My question to you as a Healthcare Leader is what are we doing about it? Our patients, clients,