Changing Health Care Landscape Poses Uncertainties

With the next wave of health care reform on the horizon, many employers are wondering how to adapt to the potential post-Affordable Care Act era and the changes it may bring.

"I wish we had a crystal ball, so we have given up trying to predict anything in health care right now ... The one thing we do know, despite all the drama on the national level and the politics in Washington, D.C., is that health care is reforming and moving away from the traditional high volume, fee for service, procedure-driven businesses to more value-based and population-based health care," said Stuart Clark, managing director and national spokesperson for Advisory Board Co. in Washington, D.C.

On Wednesday morning Clark presented the board's "Healthcare State of the Union - The Next Wave of Healthcare Reform: Repeal, Replace or Repair? Adapting Provider Strategy for the Post-ACA Era" to members and guests of the Huntington Regional Chamber of Commerce during the 2017 Healthcare Symposium. The session was presented by Cabell Huntington Hospital and St. Mary's Medical Center at the St. Mary's Conference Center on 5th Avenue in Huntington.

"The best way to think of this event is a 50,000-foot, national view of what's happening in health care," Clark said.

Xavier Staggs, an attorney with the law firm Jenkins Fenstermaker, attended the symposium to try to gain knowledge on the trends facing the business community regarding health care reform.

"It's important to know what the mandates may be for employers, and not just what will businesses be required to do, but also what businesses will be able to do if the health care laws change," Staggs said.

The general trend businesses are facing, especially hospitals and large employers, means increased pressures all around, according to Clark.

"The wave of health care reform suggests the federal government is trying to spend less and less in both Medicare and Medicaid reimbursement, and large employers increasingly now are trying to shift the rising burden of health care onto employees, which is a new trend," he said.

Clark says deductibles continue to go up, so individuals are starting to think differently about how they are going to access the health care system.

"Many are shopping around for health care services, and this is important for health care providers to understand," he said.

Clark said preparing to navigate the realities of tomorrow's health care landscape must be the top strategic aim for any health care executive. He added that this is a critical moment for hospitals and health systems.

"Let's not forget that with a new administration firmly in place and efforts by the Republican Congress to repeal and replace the Affordable Care Act well underway, health systems find themselves confronting newfound uncertainty," Clark said.

Kevin Fowler, president and CEO of Cabell Huntington Hospital, says payment and reimbursement changes with health care reform are of particular concern for hospitals.

"The health care industry is such a complex industry," Fowler said. "With all of these moving parts and changes, from Obamacare to President (Donald) Trump's plans, there is a lot of uncertainty. With that uncertainty comes a worry as to whether or not we're going to get paid for the same things we got paid for before the same way. We are still working through all of this and trying to understand it."

Fowler said he thinks the key for hospitals will be to provide very high-quality care at the lowest cost possible.

"Those are some saving points - if hospitals concentrate on them, I think we can survive this health care reform," he said. "You don't want to make a move too soon, until you see what the changes are going to be, so this event is very timely for the health care and business communities to learn more about what is going on with health care reform on a national level."

Clark said while the specific legislation that will drive the next era of reform has yet to be finalized, the timing and content of potential reforms are quickly coming into focus.

"With the Republican sweep of the White House and Congress, reducing entitlement spending and federal oversight of Medicaid have emerged as new, fundamental goals, and as the GOP prepares to inject free-market principles, transparency and greater levels of consumer choice into the health care landscape, the birth of the consumer-driven health care market is poised to become a reality," he said. "I hope those attending the symposium would get a better understanding of what it means in terms of identifying and prioritizing a series of no-regrets investments that will support success toward both population health and consumerism, including crafting a compelling risk-based contracting strategy for Medicare, as well as designing a blueprint to attract and retain consumers in an increasingly crowded and competitive marketplace."

Bill Bissett, president and CEO of the Huntington Regional Chamber of Commerce, said everyone is the business community is concerned about health care reform.

"This is a changing issue, so getting the most up-to-date information about where health care is now and where health care reform is going was the goal of this symposium," he said.

Follow reporter Fred Pace at Facebook.com/FredPaceHD and via Twitter @FredPaceHD.