political malpractice: the impact of the aca on american employers

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Speaker: Stanley Hupfeld Chairman INTEGRIS Health Foundation Moderator: Max Mihelich Associate Editor Workforce magazine

Political Malpractice: The Impact of the ACA on American Employers

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Political Malpractice: The Impact of the ACA on American Employers

Max Mihelich Associate Editor Workforce magazine

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Political Malpractice: The Impact of the ACA on American Employers

Stanley Hupfeld Chairman INTEGRIS Health Foundation

POLITICAL MALPRACTICE &

EMPLOYER CHOICES Presented by

Stanley F. Hupfeld

TABLE OF CONTENTS Highs and Lows of American Medicine Essential Question Essentials of American Medicine 14 Reasons Why the System is So Hard to Reform Formula for Employer Cost Understanding Law Employer Issues Opportunities to Improve The Reason to Act Appendix Q & A

HIGHS AND LOWS OF AMERICAN MEDICINE 12-Patient Kidney

Transplant Three States Nine Surgeons Three Hospitals

HIGHS AND LOWS OF AMERICAN MEDICINE (CONT’D)

Nation’s First Less Than Mile

Away

HIGHS AND LOWS OF AMERICAN MEDICINE (CONT’D)

Ying and Yang –

Best and Worst

ESSENTIAL QUESTION How to Deliver and

Pay For: High Quality Care Reasonable Cost Most People

ESSENTIALS OF AMERICAN MEDICINE Retail Analogy

ESSENTIALS OF AMERICAN MEDICINE (CONT’D)

Not Insurance Transfer of

Payments

14 REASONS WHY THE SYSTEM IS SO HARD TO REFORM 1. Tort System

14 REASONS WHY THE SYSTEM IS SO HARD TO REFORM (CONT’D)

2. High Overhead 3. Medicine’s

Secret 4. Hospitals as

Part of the Problem

5. Cost Shifting

14 REASONS WHY THE SYSTEM IS SO HARD TO REFORM (CONT’D)

6. History of

Entrepreneurship Social Service or a

Business 7. Lack of Continuity

14 REASONS WHY THE SYSTEM IS SO HARD TO REFORM (CONT’D)

8. Market Driven? 9. Unclear Expectations/

Our Rights as a Patient

14 REASONS WHY THE SYSTEM IS SO HARD TO REFORM (CONT’D)

10. View of Death

14 REASONS WHY THE SYSTEM IS SO HARD TO REFORM (CONT’D)

11. Variation in

Treatment

14 REASONS WHY THE SYSTEM IS SO HARD TO REFORM (CONT’D)

12. We (Patients) Are Part of

the Problem 13. American Expectations

14 REASONS WHY THE SYSTEM IS SO HARD TO REFORM (CONT’D)

14. Our Words Are Part

of the Problem We Are the Best Death Panels Health Care Decision

Only Between You and Your Doctor

FORMULA FOR EMPLOYER COST

$ = (# of Employees Covered) [EC] x (Benefits) [B] x (Use Rate of Those Benefits) [UR] x (Provider Payments) [PP]

$ = EC x B x UR x PP

UNDERSTANDING THE LAW Individual Mandate,

Health Exchanges, New Benefits

UNDERSTANDING THE LAW (CONT’D)

Employer

Mandate and Consequences

EMPLOYER ISSUES Increased Cost of

Care versus New Expensive Benefits

EMPLOYER ISSUES (CONT’D)

Employer headache Employer Must

Control at Least One Variable in Formula

Employee Dissatisfaction

What is Competition Doing?

EMPLOYER ISSUES CONT’D

Increasing Burden to

Employees Stop Coverage – Send

Employees to Internet Direct Contracting –

Cut Out Middle Man Private Exchange – Let

Employees Contract Plan

EMPLOYER ISSUES (CONT’D)

Do Employers

Continue to Support Financing Employee Health Care?

EMPLOYER ISSUES CONT’D

Focus on Wellness

OPPORTUNITIES TO IMPROVE

Implementation of Evidenced-Based Medicine

Standards for Information Technology Serious Tort Reform Use the Money Already in the System Stimulate the Emergence of a Not-For-

Profit Insurance Industry (for a complete list, see Appendix)

THE REASON TO ACT Lucy’s Story

APPENDIX (PP 141-150 IN BOOK)

1. Recommit to the Goal 2. Public Debate 3. Stimulate the Emergency of a

Not-For-Profit Insurance Industry 4. Implement the Exchanges 5. Give Employers Real Choice

APPENDIX (CONT’D)

6. Implementation of Evidenced-Based Medicine

7. Standards for Information Technology

8. Accelerate the Formation of Accountable Care Organizations

9. Physician Manpower 10. Clever Use of Tax Incentives

APPENDIX (CONT’D)

11. Hospitals as Change Agents 12. Serious Tort Reform 13. States as Laboratories 14. Money Already in the System 15. End of Life Care

Q & A

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