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Illinois Hospital Association Leadership Summit

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President. House Direction: Tri-bills. Senate Finance Committee: AHFA. Coverage ... Coverage of all those residing in the United States. 94 percent. 91 percent ... – PowerPoint PPT presentation

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Title: Illinois Hospital Association Leadership Summit


1
Illinois Hospital Association Leadership
Summit Rich Umbdenstock September 24, 2009
2
The Steep Health Care Cost Curve
3
In Illinois
  • There are more than 1.7 million uninsured in
    the state of Illinois
  • About the same number of people who live in
    DuPage and Lake counties

At a cost of about 1.8 Billion
July 1, 2008 US census data From the GAO
uncompensated care model and The Hospital Cost
Report
4
Hidden Cost on All of Us

From Center for Financing, Access and Cost
Trends, Agency for Healthcare Research and
Quality, Medical Expenditure Panel Survey, 2006.
5
At the White House
  • Coverage for all is Key
  • Affordability is
  • Central to Extending
  • Coverage for all
  • Cost Reductions are
  • a Shared Responsibility

Bottom Line Hospitals Support Comprehensive and
Meaningful Health Care Reform
6
Six Groups, One GoalBending the Cost Curve
7
Pursuit of Excellence Campaign
  • Use Field Tested Best Practices to
  • Reduce Surgical Infections and Complications
  • Reduce Central line-associated Blood Stream
    Infections
  • Reduce Methicillin-resistant Staphylococcus
    aureus
  • Reduce Clostridium difficile Infections
  • Reduce Ventilator-associated Pneumonia
  • Reduce Catheter-associated Urinary Tract
    Infections
  • Reduce Adverse Drug Events From High-hazard Meds
  • Reduce Pressure Ulcers

8
AHA Members Supportive of Reform
9
AHA Members Supportive of Reform
10
Consensus Across Bills
  • Coverage expansions to 95 to 97 percent of all
    Americans
  • Employer contribution
  • Individual contribution
  • Medicaid expansions
  • Federal subsidies to help individuals purchase
    coverage
  • Creation of insurance exchanges
  • Insurance reforms
  • Incentives for quality care
  • Delivery system reform options
  • Expanding health professions education
  • Restrictions on physician self-referral
  • Medicare and Medicaid provider cuts
  • Revenue (new taxes) component

11
Key Issues at a Glance
12
The Math in the House
218
Democrats 256
No Republican support 0
Democratic vote margin 38
52
13
Senate Finance Committee
Gang of Six
Max Baucus Chuck Grassley
(D-MT) (R-IA)
Jeff Bingaman Kent Conrad Mike Enzi
Olympia Snowe (D-NM)
(D-ND) (R-WY) (R-ME)
14
Americas Healthy Future Act of 2009
Hospitals Contributions To Reform 155b
  • Payment Rate Reductions 106.3b Market Basket
    update
  • reductions.
  • Medicare/Medicaid DSH Reductions
  • Medicare DSH 22.9b over 10 years. 75
    reduction beginning in 2015.
  • Medicaid DSH 24.9b over 10 years. Once a
    states uninsured rate is reduced by 50 DSH
    allotment is reduced by 50.
  • Readmission Cuts 2.1b over 10 years.

Coverage Extended to about 94 of people in the
Country.
15
Senate Finance Committee
16
Americas Healthy Future Act of 2009
Delivery System Reforms
  • Transitional Care Program to Reduce
  • Preventable Readmissions
  • Value Based Purchasing
  • Hospital-acquired Conditions
  • Accountable Care Organizations
  • National Program on Payment Bundling
  • Self-referral Ban

17
Americas Healthy Future Act of 2009
Rural Provisions and Other Program Extensions add
800 million over 10 years.
  • Extends the Medicare rural FLEX program
  • Extends outpatient PPS hold harmless for small
    rural hospitals
  • Extends and expands outpatient PPS hold harmless
    for sole
  • community hospitals
  • Extends cost base payment for lab services in
    small rural hospitals
  • Extends the rural community hospital
    demonstration program
  • Extends the Medicare Dependent Hospital program
  • Expands and improves the Medicare inpatient PPS
    adjustment for low
  • volume hospitals for two years
  • Extends rural add-on for ambulance services
  • Extends the exception process for therapy caps
    for two years
  • Extends payment of physician pathology services
    for certain hospitals

18
Our Key Challenges
  • Revenues as part of solution
  • Financing health reform
  • Payment reforms
  • Readmissions
  • Bundling
  • Value-based purchasing
  • Payment reductions
  • Update factors
  • IME
  • DSH
  • Delivery system reformsreadiness for
    coordinated care
  • Tax-exempt status
  • Health manpower supply
  • Delayed (or marginal) coverage expansions

Maintaininga fair andbalanced package
19
Reconciliation?
20
What You Can Do
21
Well Have to See What Happens in Washington
22
The Future Thats Occurred
23
Illinois Hospital Association Leadership
Summit Questions?
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