Becker's Hospital Review

85 PRACTICE MANAGEMENT THOUGHT LEADERSHIP the health exchanges do not simply turn into risk pools for the sick. Medicaid expansion under the ACA enabled millions more Americans to gain insurance coverage and is an essential way for lower-income communities to access the care they need. States should be given more flexible control over their Medicaid programs to encourage innovation that results in policies tailored to the needs of their residents. These chang- es should be made within the guardrails of Medicaid's fun- damental principles while leaving room for creative changes by state policymakers. While Medicaid-reliant providers are currently under wa- ter, they will drown completely if Medicaid reimbursement rates are lowered further. Providers — not politicians — are the ones on the front lines of healthcare in this country, yet we are often painted as villains who have profited from the ACA. Rarely is it reported that providers have seen their Medicare reimbursements cut by tens of billions of dollars since the ACA took effect. If politicians want to know what to do about healthcare, it would be wise to spend some more time with providers to better understand the realities of what is hap- pening on the ground. Healthcare delivery in this country can be improved through a renovation, not a demolition, of current legislation. Our lawmakers simply need to stop playing politics and work with each other, while also engaging with healthcare leaders who can offer valuable insight and practical solutions. The role of government One of the central questions at the heart of the healthcare debate has been what the government's role should be in healthcare. Since ACA repeal efforts stalled, there have even been calls from the left for a single-payer system. While this solution may sound attractive in theory, full government control of health insurance would be disastrous from both a financial and delivery standpoint. Most single-payer systems around the world have evolved into a two-tier health delivery system in which those who can afford to purchase private insurance can gain quicker access to care, while the "have nots" face long delays. Single-payer systems not only limit the ability of citizens to access care, they also stifle creativity and entrepreneurial pursuit within our industry. Considering the realities and complexities of the American healthcare system, any proposal advocating a single-payer approach should be taken off the table. Congress' inability to develop effective healthcare legisla- tion is frustrating, but should not be taken as a sign to sad- dle our industry with further micro regulations. Government has an important role to regulate and provide guidelines for how the industry should operate. Roughly 60 percent of most providers' revenue comes from Medicare or Medicaid, making the government the largest payer in the nation. The trick now is for the government to get out of its own way and stop functioning under the assumption that providers are bad actors who need incessant intervention and oversight. Frankly, it's insulting and underestimates the hard work that everyone on the provider side of the industry gives to ensure patients receive the highest quality care possible. The government is an inherently risk-averse entity, but the only way to innovate and create solutions to our most press- ing healthcare problems is for industry leaders to continue to take steps in a bold, new direction. While the relationship between payers and providers can be acrimonious, we have found ourselves on the same side of the most recent ACA repeal-and-replace debate, and more and more constructive collaborations have occurred in recent years. Developing workable healthcare policies that benefit pa- tients, providers and payers will require new, nontraditional partnerships that align providers' clinical performance and outcomes with financial incentives. But it can't be the insur- ance companies alone that benefit from efficiencies and cost savings made possible by providers. There must be value for both payers and providers — as well as consumers and em- ployers. Competition encourages all parties to work harder and, ul- timately, better. Elected officials and policymakers need to build legitimacy and reduce their unbelievable addiction to partisanship. Most importantly, over the course of this con- tinuing debate, everyone should remember to think as con- sumers and patients, and consider how they would like to be treated if they were in need of care. All should aspire to the kind of access and care that members of Congress enjoy. n 3 RD HEALTH IT + REVENUE CYCLE CONFERENCE SEPTEMBER 21-23, 2017 | HYATT REGENCY | CHICAGO, ILLINOIS 150 SPEAKERS FROM HOSPITALS & HEALTH SYSTEMS 255 SPEAKERS TOTAL The Brightest CIOs, Health IT and Revenue Cycle Experts in Healthcare REGISTER HERE www.beckershospitalreview.com/health-it-revenue-cycle-conference/ Registration@BeckersHealthcare.com OR Scott Becker or Jessica Cole at sbecker@beckershealthcare.com or jcole@beckershealthcare.com OR 800.417.2035. KEYNOTES BY George W. Bush, 43rd President of the United States of America Sugar Ray Leonard, Boxing Legend, Successful Entrepreneur and Author, The Big Fight: My Life In and Out of the Ring

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