Health Reform and its Implications for Wisconsin Hospitals, Physicians and Patients

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Health Reform and its Implications for Wisconsin
Hospitals, Physicians and Patients

• Wisconsin Chapter of ACHE
• December 11, 2009

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So how are things going in Washington D.C.?
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Wisconsin Attributes
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If we could make the rest of the nation practice
the way that Green Bay does, we would have higher
quality and significantly lower costs,- Peter
Orszag Obama Administration Budget
Chief6-11-2009
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What Will Happen?
Issues to Watch
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1. The Public Plan
Public insurance plan for some currently
uninsured and/or vulnerable insured
Who Will It Cover?
Provider Payment
Other Details
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1. The Public Plan
Some say a public option is needed to compete
with commercial plans the truth is there can be
no real competition if a public option pays for
services based on artificially low Medicare
rates. Such an approach will undermine WIs nine
provider-sponsored health plans.
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1. The Public Plan
Could cost over 1 billion annually in lost
revenue
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2. Coverage Expansion
Employer/Individual Mandate

• Or What?

• Whats the Coverage?

• Feds will dictate plan design and essential
  benefits
• Obtained through a new Insurance Exchange
• Public Plan slated to be available through
  Exchange

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2. Coverage Expansion
Expanded Medicaid Eligibility
Coverage Does Not Equal Access

• Bills fall far short of addressing current and
  future physician shortages

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3. How to Pay for It
House Bill and Senate Bills About 1 trillion
over 10 years
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3. How to Pay for It
Medicare Cuts in Play - 425-500 billion
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And the sausage factory is cranking out the
usual baloney
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What Will Happen????
Hard to predict, but today it looks like

• Extensive health insurance reforms/mandates

• 155 billion in hospital Medicare cuts over 10
  years

• Modest recognition of Value

• Bundling pilots and other payment reforms

• Place setter for physician payment geographic
  fix

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Likely Impact on Wisconsin
What Will Happen?

• Minimal expansion of Medicaid eligibility, if any

• Possible reduction in uncompensated care due to
  decrease in uninsured

• Reduced payment from Medicare

• Payment reforms will support closer
  hospital-physician integration

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Reform Politics
What do voters think?
Do You Support President Obamas Health Reform
Plan?
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Reform Politics
14 Undecided
4 Undecided
17 Undecided
2 Undecided
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When Will Something Happen?
In the Senate
- Longer process, could be January or later
- Need majority 10 (60 votes)
In the House
- Spkr. Pelosi says they will lose seats to pass
- Lost almost 40 votes first time around
Conference Committee
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Prediction
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QUESTIONS