At the Healthcare Financial Management Association’s ANI conference held June 20-23 in Las Vegas, opinion varied on the financial outlook for healthcare providers in the post-healthcare reform era.
“There is a lot of doom and gloom out there on healthcare reform,” said Jason Sussman, a CPA and partner at Kaufman, Hall and Associates, a Skokie, Ill.-based consulting and software firm.
Speaking at a June 22 ANI education session, Sussman predicted that the “nitty-gritty” details of healthcare reform would play out over the next seven years.
“For every page of law, you can expect 200 pages of regulations,” he said. “What we think we know today will be changed tomorrow.”
According to Sussman, providers’ post-reform survival plan should focus on care coordination capability, physician integration and a service distribution system.
“The given is going to be less reimbursement,” Sussman concluded.
At an ANI session titled “Medicare Changes, 2010 and Beyond,” Larry Goldman, senior legislative advisor for the global consulting firm Grant Thornton, confirmed Sussman’s concerns.
Goldman revealed the new healthcare reform laws mandate a .025 percent reduction in hospital market basket updates beginning in fiscal year 2010-2011.
That reduction, along with a hospital inpatient/outpatient productivity adjustment in 2012, could result in a negative rate of increase, he said.
To understand the bottom line, healthcare providers need to review both bills (the Patient Protection and Affordable Care Act and its companion bill the Health Care and Education Reconciliation Act of 2010), Goldman said.
Goldman agreed with other experts that the new healthcare reform laws will not be repealed, but many changes to the law can be expected.
“It’s a work in progress,” he said.
Stuart Guterman, assistant vice president and director of the program on payment system reform at the Commonwealth Fund in New York City, told ANI attendees that the new healthcare reform law aims to integrate U.S. healthcare.
“It’s hard to picture an integrated healthcare system when we have a fragmented healthcare financing system,” he said.
Under the reform law, the Centers for Medicare and Medicaid Services are mandated to develop pilots for innovative care, Guterman said.
“You can’t be sitting on your hands and waiting for CMS to tell you what to do,” he warned. “We need better and more efficient care, and your ideas are important.”