Area health care leaders in the dark about industry’s future

Jan. 27--Area health care professionals are trying to better manage the existing health care system while guessing about future changes now that a new administration has taken office in Washington, D.C.

"If we don't figure out how to ration health care, the cost of premiums could be $3,000 a month," said David Spillers, chief executive officer of the Huntsville Hospital Health System.

The fate of the Affordable Care Act, Medicare, Medicaid, mental health, health care costs and more were discussed Thursday morning at the State of Healthcare forum hosted by the Decatur-Morgan County Chamber of Commerce.

President Donald Trump and Republican leaders in the U.S. Senate and House are trying to figure out how to meet campaign promises to repeal the Affordable Care Act, commonly called Obamacare, while maintaining affordable health care and trying to reduce federal spending.

Spillers told chamber members attending the forum at DoubleTree by Hilton on Thursday that the state could suffer if federal Medicaid money is sent to states through block grants.

Block grant allocations based on how many people a state has enrolled in Medicaid would help those states that expanded Medicaid through the Affordable Care Act to receive larger block grants, he said.

Alabama, which did not expand Medicaid, could have added 400,000 people to its Medicaid rolls and received an infusion of up to $5 billion of federal money if the state had expanded Medicaid, Spillers said.

"We never got access to that money," Spillers said.

Medicaid provides health care to low-income individuals, including adults, children and people with disabilities.

The Alabama Legislature in 2013 approved a change in the state's Medicaid delivery system from a fee-for-service model to a regional care organization system. The regional groups would be paid a set amount per patient to oversee their care.

Huntsville Hospital has partnered with other health care providers to form a regional care organization named Alabama Community Care.

Kyle Buchanan, executive director of Alabama Community Care, said the aim is to improve access and care for Medicaid patients while reducing the cost.

"This is really a model for the entire country," he said.

Buchanan said an example of what the organization can do involves a Madison County woman suffering from pain and seizures who had visited the hospital emergency room 146 times in a year. The organization's team members worked with the woman to better manage her prescriptions and how she interacted with the health care system. Now, he said, she has gone to the emergency room six times in six months.

But Buchanan and Spillers both said success of the new system will depend on the Legislature supplying enough money for the regional organizations to hire employees.

The Trump administration and congressional leaders have floated a few ideas about how to repeal Obamacare and possible replacements to help people with health insurance coverage.

U.S. House Speaker Paul Ryan has advocated a plan for the federal government to issue vouchers for individuals to buy health care insurance if Obamacare is repealed, Spillers said.

"How that's going to impact an individual or a hospital, I don't know," he said.

Dr. Scott Harris, the region's state health officer, said the Alabama Department of Health would like to have some type of coverage available for up to 300,000 state residents with insurance through Obamacare.

"We would love for those people to stay insured," he said.

Jessica Payne, executive director of the Community Free Clinic of Decatur-Morgan County, said there's been a public misconception that the clinic's patients qualified for coverage through the Affordable Care Act.

But, she said, the clinic's patients are too far under the poverty level to qualify for Obamacare and too far above the poverty level to receive Medicaid.

"It was actually a very small amount of people who left us," she said.

Payne said the clinic serves about 500 people on a regular basis, but that number could increase with the new administration.

"We continue to do something for those people who fall through the cracks," she said.

[email protected] or 256-340-2438. Twitter @DD_KeithClines.

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