MemorialCare’s strong financial condition and reputation for quality help position us to face all challenges and opportunities posed by Health Care Reform. The Patient Protection and Affordable Care Act of 2010 (ACA) along with the Health Care and Education Reconciliation Act, signed into law in March 2010 represented the most far-reaching reform to the health care industry in decades. There were almost 3,000 pages of legislation between the two bills and we are expecting tens of thousands more in new rules and regulations. While passage of the bill was very controversial, one of the most positive outcomes of the new legislation is the expanded coverage for the uninsured through increased Medi-Cal enrollment or the Insurance Coverage Exchanges. Currently, almost 32 million uninsured Americans are expected to gain coverage over the next nine years, everyone will be guaranteed access to insurance by 2014, coverage on parents’ plans will extend to children up to the age of 26 and Medicaid (Medi-Cal in California) will broaden in 2014. Although the new Republican majority in the House of Representatives was not able to repeal the ACA they are determined and committed to defund many elements of the bill.
Over the next several years, the hospital industry’s shared contribution to pay for this expanded coverage exceeds $155 billion over the next 10 years and MemorialCare is expected to lose several hundreds of millions of dollars in our Medicare reimbursements. Despite these fiscal challenges, the ACA affords us the opportunity to strengthen our relationships with our physician partners in payment bundling and Accountable Care Organizations. MemorialCare’s advocacy efforts will focus on the details of these regulations as well as:
Educating our elected officials and the administration about the impact the expected decline in government reimbursement will have on our heath system. Our ability to access cost and quality data across the continuum of care will become even more important so that we can measure, improve and report our performance. We must ensure that our Medicare reimbursement, only about 82 percent of our current costs, are not further impacted. Additionally, we will advocate against any further cuts to Medicare and Medi-Cal DSH funding.
Ensure that Accountable Care Organizations (ACOs) are properly implemented so that we can grow the MemorialCare Medical Foundation and continue to advance the work of the Physician Society and enhance integration with physicians, medical groups and IPAs.
- AB 43 (Monning) - Medi-Cal Eligibility - requires the department to establish, by January 1, 2014, eligibility for Medi-Cal benefits for any person who meets these eligibility requirements. This bill would permit the department, to the extent permitted by federal law, to phase in coverage for those individuals. MemorialCare will monitor AB 43
- SB 222 (Alquist) – Plan Joint Ventures - authorizes a county board of supervisors, special commission, or health authority that governs, owns, or operates a local initiative health plan or county-organized health system or the County Medical Services Program governing board, to form joint ventures for the joint or coordinated offering of health plans. MemorialCare will monitor SB 222.
- SB 810 (Leno) – Single Payer Health Coverage - creates the California Healthcare System designed to establish a Single Payer system in California. MemorialCare opposes SB 810.
MemorialCare is well positioned to meet the challenges and opportunities presented in the health care reform bills through expense management, physician alignment continuing our remarkable success in EMR and AEMR, and further building our physician alignment.