Estimated read time: 6 minutes
This spring, health care leaders from across the country attended the American Hospital Association (AHA) Annual Membership Meeting in Washington, D.C. Annually, this event is an opportunity for health care professionals to be part of a discussion that focuses on the advocacy, regulatory and legislative issues that affect our nation’s hospitals, patients and communities.
Over the course of the meeting, attendees heard from a dynamic line up including Senate Majority Leader Mitch McConnell, Speaker of the House Nancy Pelosi, AHA President and CEO Rick Pollack, Senator Roy Blunt, Department of Health and Human Services Deputy Secretary Eric Hargan and Director of the Centers for Medicare & Medicaid Services' Innovation Center Adam Boehler. Former Secretary of State and retired four-star General Colin Powell provided the closing keynote.
We support this event to get a lens into policy and industry issues that are top of mind for our customers. While at the meeting, there were six topics and insights that kept surfacing:
1. Push to improve, not end, the Affordable Care ActAHA remains a staunch advocate for building upon the Affordable Care Act vs. “repeal and replace” or some form of Medicare-for-all. Increasing coverage and comprehensive health benefits via 1) support for expanding Medicaid in the non-expansion states; 2) stabilizing the insurance exchange and 3) increasing subsidies to lower income individuals to support buying private health care were areas of focus. AHA members were encouraged to spend time on Capitol Hill to advocate for these key areas.
2. Urgent need to prioritize rural health careAHA voiced that action is needed now to create new models of care that preserve access to health care in rural communities, such as through a new Rural Emergency Hospital designation, which is an experiment with innovative payment models and expansion of current demonstrations that are working.
“Supporting access to care in rural communities and reining in escalating drug prices are two areas that have bipartisan support and could see legislative action in a divided government,” stated AHA Executive Vice President Tom Nickels.
3. Reigning in unsustainable drug pricesThere was a lot of talk about unsustainable drug prices. With Drug costs making up 75% to 80% of health system pharmacy budgets, drug price increases that exceed inflation can have a devastating impact on a health system’s ability to serve patients.
Newer therapies can cost in the hundreds of thousands of dollars. For example, cell therapy for some types of blood cancers is around $400K per dose, immune therapy doses about $100K per patient/year and Hepatitis C medication an estimated $1K per pill – or the same cost as the average American’s mortgage. Additionally, increasing costs of older medications are a concern with insulin jumping from $40 to $275 per vial – a 680 percent increase since 2002.
The AHA has recommended a number of policy solutions to bring down drug prices, including addressing anticompetitive actions by brand name drug manufacturers, speeding up generic drug approvals and passing the Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act, which would allow generic drug manufacturers facing certain anticompetitive delay tactics to bring an action in federal court for injunctive relief.
4. Partnerships are essential for better post-acute care
David Klementz, chief strategy officer, Encompass Health shared how they are working with Cerner to focus on patient-specific data and evidence-based decision making that improves clinical outcomes and drives value-based care. Specifically, Encompass Health worked with Cerner to create a longitudinal record that provides real-time patient updates, no matter the care setting.
Additionally, this quarter Encompass is piloting a post-acute care network quality and efficiency new tool that will indicate whether the best post-acute care providers in the market are being used. It will also compare post-acute care and downstream providers nationwide and develop benchmarks.
Philip Oravetz, M.D., chief population health officer of Ochsner Health System, provided insight on their post-acute care strategy that is anchored by key partnerships in long-term acute care, rehab, skilled nursing facility, home health and home care. Goals consisted of improving quality, coordinating care, keeping care local, serving more patients and making care affordable. To do this, Ochsner established a network of preferred providers, developed tools for patient “informed choice” and held monthly performance improvement meetings, as well as, quarterly regional meetings. The outcome demonstrates that integrated partners perform better for their patients, including patients that average a seven-day shorter length of stay.
5. Medical bills shouldn’t be a surpriseOne issue that both political parties seem to agree on is the need to address surprise billing. About 1 in 7 people have received, or know someone who has had, a surprise medical bill. AHA is advocating for policy that protects patients from the three most typical scenarios: (1) a patient accesses emergency services outside of their insurance network, including from providers while away from home; (2) a patient unintentionally receives care from an out-of-network physician providing services in an in-network hospital or (3) a health plan denies coverage for emergency services saying they were unnecessary.
6. Low-income patients need expanded health care coverage
As mentioned earlier, expanded health care coverage via state Medicaid expansion was a hot topic. Medicaid pays for health care for more than 74.5 million people nationally. Although participation is optional, all 50 states are enrolled in the program. And while eligibility for Medicaid benefits varies widely, the states have options for expanding Medicaid beyond the minimum federal guidelines. The decreased Medicare and Medicaid Disproportionate Share Hospital (DSH) payments to hospitals that serve a higher-than-average number of low-income patients could negatively impact hospitals in states with their own support funding for uninsured patients.
The AHA meeting is another reminder that we as health care leaders must continue to innovate and set the pace for transforming the future of health care. With a focus on leaping toward advancement on these important topics, and others, we can deliver smarter care and better outcomes.
It’s Cerner’s mission to relentlessly seek breakthrough innovation that will shape the health care of tomorrow. And we believe that what we do doesn’t just impact health care – it impacts the world. Learn more here.
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