Archives     Advertise     Editorial Calendar     Subscribe     Contact Us    


As Healthcare Evolves, We Must Address Challenges - and Preserve Our Progress


 

An important Open Enrollment deadline is quickly approaching. Tomorrow, December 15, is the last day to apply on HealthCare.gov for healthcare coverage beginning January 1, 2017.

Even as we prepare for the coming year, it is worth taking a look back at several significant events that occurred over the past few months. This fall, thousands of Tennesseans - including many of the people we serve - found themselves in a difficult situation when a major insurer decided to end individual marketplace plans in several cities, including Nashville. At the time, the other marketplace plans did not include Saint Thomas Health, which meant that when our patients switched to a different plan they would also have to switch to a different doctor. For a healthy person, choosing a new doctor can be frustrating. But for someone receiving care - the woman expecting her first child in January or the cancer patient who has three chemotherapy treatments left - it can be devastating.

For Saint Thomas Health, which is part of Ascension, the nation's largest non-profit healthcare system, the prospect of not being able to care for our current patients was unacceptable. We started negotiations with health insurance companies that still offered marketplace plans and quickly signed an agreement with Cigna. The agreement allows people who enrolled in a Cigna Connect plan to continue in-network care with Saint Thomas Health.

The Affordable Care Act, which passed in 2010, ushered in a new era of healthcare. Many of the changes that were part of this law were welcome. More than 20 million people gained access to healthcare. People with pre-existing conditions are no longer denied health insurance, and women aren't charged more simply because they are women.

We also started to see a broad industry shift as health systems, such as ours, worked to meet the demands of this new era and better serve our patients. Step by step, we have been moving toward a future in which patients' care is better coordinated from visit to visit; where greater efficiency leads to lower costs; and where doctors and hospitals are paid based on the value they provide, not the number of patients they see or procedures they perform.

While we've made good progress, there are challenges that still need to be addressed. Approximately 29 million people across the country still cannot afford healthcare, either because the policy premiums are too expensive in the first place or because they cannot shoulder their high co-pays and deductibles.

But there are also opportunities ahead. The strategic decisions that our health system, and many others, have made to better integrate care and begin the transition to value-based payments are the right ones. Now, we must roll up our sleeves and begin a meaningful conversation with our newly elected officials, business and community leaders, and even our friends and family about how we can address these challenges - while also preserving the progress we've made.

As part of Ascension, we are blessed to have a leading voice on the national stage as we advocate for our goal of 100 percent access and 100 percent coverage. We are in the middle of great change, and sometimes it is hard to see where the road may lead. But in the midst of this uncertainty, one thing is certain: All Americans and all Tennesseans deserve access to affordable healthcare.

It is imperative that we advocate for healthcare legislation that serves our communities, and this means being heard both in Tennessee and nationally. No matter how healthcare evolves, Saint Thomas Health and Ascension will continue to advocate for 100 percent access and 100 percent coverage. And until that happens, we will turn our words into actions by providing care to all persons with special attention to those living in poverty and the most vulnerable among us.


Karen Springer is president and CEO of Saint Thomas Health and senior vice president and the Tennessee ministry market executive for Ascension Health, the largest not-for-profit health system in the United States.

 
Share:

Related Articles:


Recent Articles

The 2019 Legislative Agenda

A new governor and many new legislators make 2019 a learning year as the state's top healthcare organizations seek to address a number of old issues and tweak some new solutions unveiled last year.

Read More

Updated Cholesterol Guidelines Take a Personalized Approach

The American Heart Association and American College of Cardiology released updated cholesterol clinical guidelines in November 2018, taking a more nuanced approach to care over a patient's lifetime.

Read More

Sharing Data, Saving Lives

In an increasingly connected medical ecosystem where patient safety, health status improvement, and provider reimbursement are impacted at every point along the continuum, the need to efficiently, securely share data appears to have reached a tipping point.

Read More

New Rules in Heart Disease

A number of guideline changes and updates warrant more education around statin use and blood pressure monitoring, but local cardiologists say the higher standards are a game changer.

Read More

Dr. Ashish Shah: A Heart for Transplant Patients

Dr. Ashish Shah is the driving force behind the growth and innovation at one of the nation's busiest heart transplant programs.

Read More

Heart Monitor

Cardiovascular news of note.

Read More

ECMO Program Thriving at TriStar Centennial

A TriStar Centennial, a team approach is key to hospital's successful ECMO program.

Read More

Alexander Looks for Innovation, Asks Council Fellows for Input

Sen. Lamar Alexander asks stakeholders and future leaders to weigh in on ways to improve health outcomes, lower costs.

Read More

CMS Utilizes Dartboard Approach to Modernizing the Medicare Drug Benefit

Controlling pharmaceutical prices remains a hot topic, judging from the 6,415 comments received in response to the CMS proposed rule: "Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses."

Read More

A Conversation with LHC Director Molly Vice

Every company should have a succession plan. LHC plays a key role in planning for the next generation of leaders for an entire industry.

Read More

Email Print
 
 

 

 


Tags:
Affordable Care Act, Ascension Health, Karen Springer, Saint Thomas Health
Powered by Bondware
News Publishing Software

The browser you are using is outdated!

You may not be getting all you can out of your browsing experience
and may be open to security risks!

Consider upgrading to the latest version of your browser or choose on below: