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
#WFwebinar
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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