Healthcare Reform Briefing: by James Person

Healthcare Reform Briefing
by James Person
Presented to the NorthLake Association of Medical Managers
September 21, 2011
Biography
James Person is the Public Affairs Specialist for St. Tammany Parish Hospital. He is responsible for analyzing the effects of federal, state and local legislation and regulations on the hospitals ability to deliver worldclass healthcare close to home. He also assists with external and internal communication efforts. Person previously served on Capitol Hill as a legislative aide for two Members of Congress and a prominent public policy think tank. He also managed and worked on congressional election campaigns in North Carolina, Wisconsin and Louisiana.
He is a native New Orleanian and an alumnus of Mandeville High School and Louisiana State University- Baton Rouge where he received a Bachelor of Arts degree in Mass Communication. Currently, he attends the University of New Orleans where he is earning a Master of Business Administration degree concentrating in finance. He lives in Mandeville with his wife and two sons.
Overview
Super Committee
Whats Left to Do
Outlook Presidents Proposals
Healthcare Reform
Super Committee
Super Committee
Stage 1- Budget Control Act

Immediate budget reductions of $917 B
Super Committee
Immediate budget reductions of $917 B

Extends debt limit by $900 B until Feb/March
Super Committee

Immediate budget reductions of $917 B Extends debt limit by $900 B until Feb/March
No cuts to Medicare or Medicaid
Super Committee

Immediate budget reductions of $917 B Extends debt limit by $900 B until Feb/March No cuts to Medicare or Medicaid No tax increases
Super Committee
Stage 2 Find $1.5 T in deficit reduction recommendations by Thanksgiving
Super Committee
Stage 2
Find $1.5 T in deficit reduction recommendations by Thanksgiving
If a deal is reached: Up-or-down clean vote in Congress
Super Committee
Stage 2
Find $1.5 T in deficit reduction recommendations by Thanksgiving
If a deal is NOT reached: Sequestration
Super Committee
Sequestration
$1.2 T in cuts
Super Committee
Sequestration
$1.2 T in cuts Automatic, across-the-board
Super Committee
Sequestration
Cuts $123 B from Medicare
Super Committee
Sequestration
$1.2 T in cuts
Automatic, across-the-board
Cuts $123 B from Medicare

Medicaid exempt
Super Committee
Sequestration
Cuts $123 B from Medicare Medicaid exempt If deal <$1.5 T, pro rata cuts
Super Committee
Sequestration
Some groups may actually prefer this!
Important Dates
October 14: Congressional committee recs due
Important Dates
October 14: Congressional committee recs due November 23: Super committee votes
Important Dates
October 14: Congressional committee recs due
November 23: Super committee votes

December 23: House and Senate votes
Options
Medicaid ($100 B)
Options
Medicaid ($100 B)
No more provider taxes
Options
Medicaid ($100 B)
No more provider taxes Blended FMAP rates
Options
Medicare
Options
Medicare
IME cuts ($15 B)
Options
Medicare
IME cuts ($15 B)
Eliminate bad debt payments ($15-$30 B)
Options
Medicare
IME cuts ($15 B) Eliminate bad debt payments ($15-$30 B) Others ($69-$71 B)
Options
Medicare
IME cuts ($15 B) Eliminate bad debt payments ($15-$30 B) Others ($69-$71 B) Expansion of IPAB
Options
Other
Increase retirement age ($125 B)
Means-testing ($38 B)
Medicare copay reform and increases ($110 B) Medigap restrictions ($53 B) Home health copays ($40 B)
SNF copays ($50 B)
Whats Left to Do?
Expiring tax provisions AMT patch R & D tax credits Accelerated depreciation
Whats Left to Do?
Expiring tax provisions AMT patch R & D tax credits
Accelerated depreciation
Medicare DOC FIX !!!! ($300 B)
Doc Fix
MedPAC doc fix proposal
Doc Fix
MedPAC doc fix proposal Cut specialist payments 6%
Doc Fix
MedPAC doc fix proposal

Cut specialist payments 6%
Keep PCP rates flat
Doc Fix
MedPAC doc fix proposal Cut specialist payments 6% Keep PCP rates flat Paid for with cuts to other healthcare sectors
Outlook
Outlook
Outlook
Outlook
Jobs Proposal
Reduce payroll taxes

Increase spending by $447 B
Jobs Proposal
Reduce payroll taxes Increase spending by $447 B

paid for with
Jobs Proposal

paid for with
Tax increases and limiting itemized deductions
Jobs Proposal

paid for with
Tax increases and limiting itemized deductions
Deficit Reduction Proposal
Save $3.5 T over 10 years

$320 B from Medicare and Medicaid
$320 B from Medicare and Medicaid

$248 B from Medicare $73 B from Medicaid

$320 B from Medicare and Medicaid $248 B from Medicare
$73 B from Medicaid

OMB baseline assumes doc fix?!
No cuts to Social Security
No structural changes to Medicare

No benefit changes
Blended FMAP MOE No provider taxes ($26 B) Increase
MedPAC recommendations
o IME cuts
o Bad debt payment cuts o Medical imaging utilization rate cuts
IPAB
PPACA:
Medicare spending per beneficiary
>
GDP growth + 1%
IPAB
Obama deficit reduction:
>
GDP growth + 0.5%
IPAB
>
GDP growth + 0.5%
IPAB
>
GDP growth + 0.5%
Sequestration
IPAB
>
=
GDP growth + 0.5%
Sequestration
Provider CUTS
Healthcare Reform
Healthcare Reform
Policy MGMA Principles

Fix the Medicare physician payment system
Simplify administrative transactions
Medical liability reform

Expand coverage Improve quality and safety Promote adoption of HIT
Policy
MGMA Statement MGMA cannot support this final legislation HCR fails to address SGR and payment fix Independent Payment Advisory Board (IPAB) No meaningful federal medical liability reform Cuts to the technical component of imaging services
Physician-self referral ban

Administrative simplification not fully realized
Expanding Coverage to 32 Million

What Would Happen Under Reform
25 million
158 million
Source: Congressional Budget Office
Coverage: Insurance Exchanges

In 2014, all individuals will be required to obtain coverage or face a penalty. Individuals can purchase coverage from newly created insurance exchanges. Federal help for some individuals to pay for insurance.
Coverage: Insurance Exchanges
Questions

Healthcare Reform Briefing: by James Person

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Healthcare Reform Briefing: by James Person

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Healthcare Reform Briefing

Stage 1- Budget Control Act

Stage 1- Budget Control Act

Immediate budget reductions of $917 B

Stage 1- Budget Control Act

No cuts to Medicare or Medicaid

Stage 1- Budget Control Act

Stage 2 Find $1.5 T in deficit reduction recommendations by Thanksgiving

If a deal is reached: Up-or-down clean vote in Congress

If a deal is NOT reached: Sequestration

Cuts $123 B from Medicare

Cuts $123 B from Medicare

October 14: Congressional committee recs due

October 14: Congressional committee recs due

November 23: Super committee votes

Eliminate bad debt payments ($15-$30 B)

SNF copays ($50 B)

Whats Left to Do?

Whats Left to Do?

Expiring tax provisions AMT patch R & D tax credits

MedPAC doc fix proposal

MedPAC doc fix proposal Cut specialist payments 6%

MedPAC doc fix proposal

Keep PCP rates flat

Reduce payroll taxes

Reduce payroll taxes Increase spending by $447 B

Reduce payroll taxes

Increase spending by $447 B

Tax increases and limiting itemized deductions

Reduce payroll taxes

Increase spending by $447 B

Tax increases and limiting itemized deductions

Deficit Reduction Proposal

Deficit Reduction Proposal

Deficit Reduction Proposal

Save $3.5 T over 10 years

Deficit Reduction Proposal

Save $3.5 T over 10 years

Deficit Reduction Proposal

Save $3.5 T over 10 years

$320 B from Medicare and Medicaid

Deficit Reduction Proposal

Save $3.5 T over 10 years

$73 B from Medicaid

Deficit Reduction Proposal

No cuts to Social Security

No structural changes to Medicare

Deficit Reduction Proposal

Blended FMAP MOE No provider taxes ($26 B) Increase

Deficit Reduction Proposal

Deficit Reduction Proposal

Deficit Reduction Proposal

GDP growth + 0.5%

Deficit Reduction Proposal

GDP growth + 0.5%

Deficit Reduction Proposal

Deficit Reduction Proposal

GDP growth + 0.5%

Deficit Reduction Proposal

GDP growth + 0.5%

Policy MGMA Principles

Medical liability reform

Physician-self referral ban