Becker's Hospital Review

8 2. The Election, the ACA and More. is was a fascinating election. is is a non- partisan comment. Whether a Republican or a Democrat, it has substantial consequences. One of the more interesting issues is that it causes a reevaluation of the ACA. ere have been many observations made about the ACA. In simple terms, it provided insurance cover- age to 20 million previously uninsured people at a tremendous cost. Here, we can weigh the pros and cons of that effort. It is hard to be negative in a vacuum about adding insurance coverage for 20 million people. At the same time, everything should be done in a cost effi- cient and rational way. Moreover, it erodes free enterprise if the rules of the game become big ticket and constant simple or complex redis- tribution of wealth. I think the four largest positives of the ACA are as follows: First, coverage for 20 million people. Here, it's estimated that 16 million of these have been added via Medicaid plans. Second, the redesign of the system in some places has led to a seismic jolt in the use of telehealth. Telehealth is incredibly cheaper than office-based healthcare and in some plac- es they are estimating that nearly 40 percent to 50 percent of patient visits are completed by telehealth. is is particularly true in places such as Kaiser Permanente, where the verti- cally integrated system is dramatically driving down costs by moving things greatly toward telehealth. System CEO Bernard Tyson re- ported 52 percent of 2015 patient interactions at Kaiser Permanente were held online, via virtual visits or through the Kaiser-branded apps. By fully aligning the system in a non-fee for service way, Kaiser has been inventive and aggressive about driving down costs. e third largest positive under the ACA is the move- ment of consumers toward actually watching their healthcare costs as their deductibles and costs have gone up. However, even though I see this as a clear positive, it is hard to see the benefits so far as healthcare premiums and costs continue to rise significantly. Fourth, the ACA has made it easier to gain coverage for people with pre-existing conditions. On the negative side: First, healthcare pre- miums and costs have not decreased at all. Second, if anything, the ACA has led more to the concept of market domination as a strat- egy for success financially by health systems. It is difficult to link provider consolidation spurred by the ACA to any savings — studies that examine the correlation between the two yield mixed results. ird, the ACA has added trillions in total costs and billions in adminis- trative costs to the federal budget, leading to increased costs and taxes for most Americans. It will be fascinating to see what happens with the ACA. Like with most things, once people have gotten used to a benefit, in this case, in- surance coverage for 20 million people, it is hard to see the country taking the hard tack (even though it may save billions of dollars) of not providing a means to obtain healthcare coverage (note 16 million of the 20 million are in Medicaid plans). us, I think it will be fas- cinating to see how this actually unfolds. 3. Conferences for 2017. We have add- ed some amazing speakers and keynotes for next year. In the first half of the year, we have Arnold Schwarzenegger, Jay Leno and eight of the greatest hospital CEOs in the country taking the podium, as well as 233 hospital ex- ecutives speaking at our Annual Meeting. at meeting runs from April 17 to 20. Come for one, two or four days. Here, the keynotes and keynote panelists include: Annual Meeting 1. Arnold Schwarzenegger, 38th Governor of California and Cultural Icon 2. Marna Borgstrom, MPH, CEO, Yale New Haven Health and Yale New Haven Hospital 3. Delos M. Cosgrove MD, President and CEO, Cleveland Clinic 4. Michael J. Dowling, President and CEO, Northwell Health 5. Rodney F. Hochman, MD, President and CEO, Providence Health & Services 6. Jay Leno, Comedian and Former Host, "e Tonight Show" 7. Redonda Miller, MD, MBA, President, e Johns Hopkins Hospital 8. John Jay Shannon, MD, CEO, Cook County Health and Hospitals System 9. Johnese Spisso, MPA, President, UCLA Health; CEO, UCLA Hospital System and Associate Vice Chancellor of Health Sciences 10. Nancy Howell Agee, President and CEO, Carilion Clinic 11. Barry Arbuckle, PhD, President and CEO, MemorialCare Health System 12. Lloyd Dean, President and CEO, Diginity Health 13. Laura Forese, MD, MPH, Executive Vice President and COO, NewYork-Pres- byterian 14. Steven Goldstein, President and Chief Executive Officer, Strong Memorial Hospital 15. Robert C. Garrett, FACHE, Co-CEO, Hackensack Meridian Health 16. Charles Lauer, Author, Consultant, Speaker, Former Publisher, Modern Healthcare 17. Stephen Mansfield, PhD, FACHE, President and CEO, Methodist Health System 18. Anthony Mercando, MD, FACC, FAHA, Cardiologist, NYP Medical Group/ Westchester; Associate Clinical Professor, Medicine, Columbia University College of Physicians and Surgeons 19. Richard Nesto, MD, Executive Vice President and CMO, Lahey Health 20. Randy Oostra, DM, FACHE, President and CEO, ProMedica 21. Stephen Rosenthal, President and COO, Montefiore Care Management 22. Michael T. Rowan, FACHE, President, Health System Delivery and COO, Catholic Health Initiatives 23. omas Sadvary, CEO, HonorHealth 24. Lou Shapiro, President and CEO, Hospital for Special Surgery 25. Warner omas, President and CEO, Ochsner Health System 26. Rhoda Weiss, PhD, National Health- care Consultant, Speaker, Educator, Author, Managing Healthcare Reform: Ideas for Leaders Spine and ASCs For our June Spine+ Orthopedic, Spine and Pain Management Driven ASC Conference, we have 140 great surgeons speaking — a re- cord number. We also have Lou Dobbs and Marcus Allen speaking as keynotes. We are looking forward to what should be a great meeting of minds and ideas. Fall Events Finally, we are planning our 3rd Annual Health IT + Revenue Cycle meeting as well as our October ASC Meeting and our November CEO + CFO Roundtable Meeting for later in the year. For the Health IT + Revenue Cycle Meeting, we have booked President George W. Bush and Sugar Ray Leonard. at also should be a fascinating meeting. For a discussion on any of the issues included here or to talk about any other issues, please contact me at (312) 750-6016 or sbecker@mc- guirewoods.com or Kirsten Doell at kdoell@ mcguirewoods.com or at (312) 750-3506. We look forward to speaking with you. Very truly yours, Scott Becker

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