Members of Leadership Health Care, an initiative of the Nashville Health Care Council, embarked on their 12th annual trek to Washington, D.C. last month to gain insight on implementation of the Affordable Care Act and other pressing national health agenda topics.
Nearly 100 of the area’s emerging industry leaders made the trip March 10-11 for two days of meetings with lawmakers, Obama administration officials, key national healthcare association leaders, and Capitol Hill staff members who are actively involved in influencing and implementing health policy. The group heard from a number of speakers regarding insurance exchange enrollment and new models of care and reimbursement.
On the first day, Michael Ramlet, founder and editor of “The Morning Consult,” a digital media company, discussed the impact of the exchanges and said data released in the coming weeks would give the industry a better idea of whether or not enrollment will hit the projected goal of 7 million. The last estimates put enrollment at a little more than 4 million. However, Ramlet continued, he thinks a story not being told often or loudly enough is that 20 percent of those enrolled have not paid their premiums … so they actually don’t have coverage.
Keynote speaker Dora Hughes, a former White House advisor and CMS official who is now senior policy advisor in the government strategies group of law firm Sidley Austin, said another concern are the more than 5 million who don’t have affordable access to coverage since they don’t qualify for subsidies on the exchanges and live in states, like Tennessee, without Medicaid expansion.
A ‘lively’ panel discussion also focused on ACA implementation. Tom Nickels, senior vice president for Federal Relations at the American Hospital Association, said he anticipates it will take three years to get coverage … whether through Medicaid expansion or the exchanges … to the desired levels. “So I think judgment ought to be suspended at least until we get to the end of 2016,” he said.
A more immediate impact of ACA, however, is expected to be felt by elected officials. Ramlet pointed to a poll that shows independent voters evenly split on which of the major parties they trust more on healthcare issues. He noted what happens in the next few months will be critical at the polls for mid-term elections and beyond. John Harris, editor in chief for the non-partisan POLITICO, talked about the current climate in the nation’s capital and the possibilities of the Republican Party regaining control of the Senate.
Day two centered on time with elected officials including Sen. Lamar Alexander (R-TN), Sen. Bob Corker (R-TN), Sen. Rand Paul (R-KY) and Rep. Jim Cooper (D-TN). After a breakfast reception, Sen. Paul said the healthcare system was broken largely because market forces had been removed with neither the consumer nor provider actively engaged in thinking or caring about price. He said future generations would bear the brunt of the explosion in costs without meaningful reform.
Cooper agreed healthcare spending must be controlled. He noted by 2040, every available tax dollar would have to go to Social Security, Medicare and Medicaid if spending growth isn’t curbed. However, he also said there has been a slowdown in that growth over the last few years for a number of reasons including efforts by the industry to improve quality and efficiency.
“We’ve got to make it continue, no matter how painful it is for your individual company or for the industry,” Cooper told the group.
He also challenged those in attendance to make Nashville more of a health policy center and to search for solutions to improve the industry considering the depth and breadth of expertise in Middle Tennessee.
“This is not someone else’s problem … this is not another generation’s problem,” Cooper said. “This is why you, who are currently in positions of power and influence in your companies, need to figure this out and need to have business plans that make the problem better.”
Before flying out, the LHC delegation also heard from Rahul Rajkumar, MD, JD, FACP, a senior advisor to the director of the Center for Medicare and Medicaid Innovation, regarding some of the 20 payment and delivery model systems being tested across the country. He pointed to the recent decline in healthcare spending as a signal the changes being made “are beginning to bear fruit.”
Ted Lomicka, LHC chairman and vice president and assistant treasurer for Community Health Systems, summed up the trip, saying, “The great thing about the delegation is that attendees get direct insight into the healthcare discussions that impact policy decisions in Washington. Delegates can take that information home and apply it to their business strategies.”