Friday, September 21, 2012

July 2012 Readers’ Poll Results

The FHIcommunications Readers' Poll for July was conducted in partnership with Marcum Healthcare. We asked:

Now that SCOTUS has ruled on the ACA, what will small employers do with regard to health benefits?

There were a total of 175 participants in the poll. 31% believe small employers will not provide health benefits and therefore pay a fine.  Reflecting a concern voiced by many on both sides of the aisle, just 7% of subscribers feel undersized firms will continue to offer health benefits as before, understanding premiums are expected to keep rising. The majority of participants (56%) are of the opinion that companies will opt to offer reduced health benefits that still meet ACA criteria (i.e. much larger family and individual deductibles). As always we encouraged readers to write in their own answers. Some suggested firms will reduce workforce to below fifty full time employees to avoid a fine. Other, more optimistic participants suggested that companies will look at products on the Insurance Exchange.

Editor's Note: Percentages will not add up to 100 due to rounding errors and write-in votes.

Friday, September 7, 2012

Critical Conversations in Healthcare


The South Florida Business Journal recently hosted a healthcare panel discussion featuring some of the biggest names in the local healthcare community.

Included on the panel were:

  • Jerry Fedele: President and CEO Boca Raton Regional Hospital
  • Brian E. Keeley: President and CEO Baptist Health South Florida
  • Jeffrey B. Kramer: CPA, Partner Goldstein Schechter Koch
  • Lee F. Lasris: Founding Partner Florida Health Law Center
  • Penny Shaffer: Market President, Florida Blue & immediate Past Chair of the Greater Miami Chamber of Commerce
  • Mike Segal: Partner Broad and Cassel
  • Dr. Fernando Valverde: CEO Florida International University College of Medicine Health Care Network
  • Dr. Steven G. Ullmann: Director of Programs University of Miami Center for Health Sector Management 
Not surprisingly the discussion focused on the future of healthcare delivery in the post SCOTUS ACA decision world.  Refreshingly the conversation focused on the policy issues and challenges without overt political partisanship.

Editor's Note:  To save space, initials of panelists are used throughout. 

JF pointed out that there is profound pressure on the health industry regardless of the ACA.  He stated that end of life care is a critical issue left unaddressed by the new health law.  Mr. Fedele predicts "intense" consolidation of providers and insurers.

BK foresees a market-driven solution to the cost crisis, not an ACA solution.  His organization is focusing on four things to prepare for the future:

1.     Physician Integration (i.e. aligning incentives)

2.     Huge Investment in IT

3.     Commitment to Family Medicine

4.     Wellness and Prevention Initiatives   

JK observed that small groups struggle to cope with the rapid pace of change.  He cited as examples EHR adoption, myriad rules and regulations as well as payment reform.  Since solos and small groups can't afford the expertise necessary to affect necessary changes within their practices, they look to be employed or combine to form larger groups.  

LL sees contraction in the healthcare marketplace as well as increased use of physician extenders (nurse practitioners and physician assistants) and changes in physician compensation programs to control cost.  

PS asserted that true healthcare reform would address access, quality and cost.  She laments that the ACA deals with access pretty well but is deficient in solving the quality and cost issues.   

MS emphasized that Fee-for- Service is a thing of the past and solo docs are out of business.  He stated that ACO's are emergent, a "sea-change". Mr. Segal also pointed out that the ACA is only part of the massive transformation going on in the health industry currently.  

FV expressed a profound concern for an imminent physician shortage.  He predicts that ARNP's and PA's will assume a huge role in primary care with physicians migrating to the specialties.

SU foresees increased demand for well educated and trained practice and facility administrators.  He warned that Medicare's survival relies on reimbursement cuts that may be draconian.