Although it’s quieted down some, a U.S. Supreme Court ruling a month ago upholding the new federal Affordable Healthcare Act is still on the minds of many people. Both presidential candidates are using this issue as a springboard for their campaigns this year. Across the country people are hearing different stories and seeking solid answers.
Among those seeking solid answers are those within the healthcare industry itself. Noyes President and CEO Amy Pollard and Chief Financial Officer Jay Maslyn sat down with the Express to discuss how this new bill could effect the hospital.
Maslyn, about halfway into the interview, summed it up this way: “Overall, we anticipate it’s going to have a negative impact on rural providers in particular. The issue really is getting your arms around how much.”
He added that the impacts will be a little different for every provider. “And that’s our challenge.”
Pollard discussed first the matter of the Supreme Court’s ruling that individual states have the authority to determine the scope of its Medicaid coverage, not the federal government.
New York already has “a very robust Medicaid program,” she said, and doesn’t foresee a change there.
Maslyn talked about a hospital’s “disproportionate share” payment through Medicare.
Medicare and other federal programs only cover a fraction of the cost of service. In most cases, hospitals and doctors make up the difference through higher amounts billed to patients who pay cash or have private insurance. If a hospital has a larger number of patients on Medicare, the hospital gets a larger Medicare payment.
If everyone becomes insured, “they’re saying there’s no need for disproportionate share. So that’s going away,”?Maslyn said.
Pollard said more people on insurance may not necessarily cover the costs of Noyes losing its disproportionate share payments.
“To lose that payment is probably going to hurt most hospitals,” she said.
She also said that having a mandate for health insurance doesn’t mean that people will enroll in it — even Medicaid — a problem the hospital already sees; and the government’s penalty that will be imposed for people not having insurance will be hefty, she said.
On top of that, she said that putting an insurance card in everyone’s hand won’t mean they will be guaranteed healthcare. There are some practitioners that do not accept certain insurances, including Medicaid, Medicare and workers compensation.
Although it’s quieted down some, a U.S. Supreme Court ruling a month ago upholding the new federal Affordable Healthcare Act is still on the minds of many people. Both presidential candidates are using this issue as a springboard for their campaigns this year. Across the country people are hearing different stories and seeking solid answers.
Among those seeking solid answers are those within the healthcare industry itself. Noyes President and CEO Amy Pollard and Chief Financial Officer Jay Maslyn sat down with the Express to discuss how this new bill could effect the hospital.
Maslyn, about halfway into the interview, summed it up this way: “Overall, we anticipate it’s going to have a negative impact on rural providers in particular. The issue really is getting your arms around how much.”
He added that the impacts will be a little different for every provider. “And that’s our challenge.”
Pollard discussed first the matter of the Supreme Court’s ruling that individual states have the authority to determine the scope of its Medicaid coverage, not the federal government.
New York already has “a very robust Medicaid program,” she said, and doesn’t foresee a change there.
Maslyn talked about a hospital’s “disproportionate share” payment through Medicare.
Medicare and other federal programs only cover a fraction of the cost of service. In most cases, hospitals and doctors make up the difference through higher amounts billed to patients who pay cash or have private insurance. If a hospital has a larger number of patients on Medicare, the hospital gets a larger Medicare payment.
If everyone becomes insured, “they’re saying there’s no need for disproportionate share. So that’s going away,”?Maslyn said.
Pollard said more people on insurance may not necessarily cover the costs of Noyes losing its disproportionate share payments.
“To lose that payment is probably going to hurt most hospitals,” she said.
She also said that having a mandate for health insurance doesn’t mean that people will enroll in it — even Medicaid — a problem the hospital already sees; and the government’s penalty that will be imposed for people not having insurance will be hefty, she said.
On top of that, she said that putting an insurance card in everyone’s hand won’t mean they will be guaranteed healthcare. There are some practitioners that do not accept certain insurances, including Medicaid, Medicare and workers compensation.
“So by adding 30 million people [on Medicaid] or 20 million whatever it is ... there’s just no guarantee there,”?Maslyn said, adding that irrespective of healthcare reform, there will likely become a shortage of physicians.
Maslyn cited a recent New York Times article that stated many physicians are fed up with the whole system, and that the new healthcare reform bill has convinced aging baby boomer physicians that it’s time to retire.
“All these trends in healthcare is what has driven Noyes and other hospitals to align themselves with a bigger entity,”?Pollard said, referring to the recent collaboration with the University of Rochester Medical Center. “You have to be part of some bigger system that’s going to give you some backup, some flexibility, some bigger plan to care for the whole population of this region of Rochester.”
She said that the collaborative partnership will help Noyes deal with the challenges, “some of which we can’t even define yet.”
Maslyn said that the increase in insurance regulations regarding documentation procedures, and adding non-clinical staff to meet those demands, has recently exploded. The new healthcare act will likely exacerbate those demands.
To make matters more complex, insurance companies have differing criteria as to how those documentations are to be done, and those criteria change on a regular basis.
On a positive note, Pollard believes that implementing new core measures and “bundles of care” that gives a standard to care and causes outcomes to become more predictable, will be a good thing. Maslyn noted that efforts in creating a reduction in hospital readmissions, reduced infection rates and better coordination between various types of health providers will also be a plus.
While some portions of the Affordable Healthcare Act have been enacted, the full law is scheduled to go into effect in 2014.
