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Cuts, indigent costs and Supreme Court could force changes in health care

Costs, cuts could force industry to make adjustments

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Providers are likely to be a little woozy this year after a number of factors – including increasing indigent costs, cuts and mergers – shake up the health care landscape, Augusta hospital leaders said.

The U.S. Supreme Court is expected to rule in the spring on the constitutionality of aspects of the Patient Pro­tection and Affordable Care Act. The presidential election, with many Republican candidates lambasting the health reform law, could also affect its fate. Though some provisions have yet to take effect – notably the ability to buy health insurance through state exchanges and the individual mandate to have it – much of it is already in place.

“Depending upon what happens in the election they could certainly modify that, but I will tell you that they have pushed very hard in Washington to institute as much of the Patient Protection and Affordable Care Act as they possibly can,” said Jim Davis, the CEO of University Hospital. “Unwinding that is going to be very, very difficult to do. And no one has a better solution right now.”

On the local level, Univer­sity is in the process of acquiring McDuffie Regional Medi­cal Center, which had struggled to get access to capital to modernize its facilities. University has also acquired a number of physician practices and is negotiating with more.

That trend can be seen nationally in Pennsylvania, with Highmark Inc. affiliating with West Penn Allegheny Health System, and with UnitedHealthcare acquiring 2,000 physicians in southern California, said David Hefner, the executive vice president for clin­ical affairs for Georgia Health Sciences University. With cuts to reimbursement now pending, you need more size and volume to achieve a working margin, Davis said.

“What a lot of organizations are starting to figure out is that it is very hard to do unless you become part of bigger organizations where you can get economies of scale,” he said. “Scale is going to be a big thing as consolidation is forced upon our industry due to the need to reduce cost. I think you’re going to see a lot of that in health care over the next year or two.”

Hefner said it “could be the new normal” as the factors play off one another.

The recession has resulted in more
uninsured. University projects its indigent costs will have doubled in three years by the end of 2012.

As more people lose their jobs and health insurance, the more likely they are to put off routine care, Davis and Hefner said. Now sicker, they show up in emergency rooms and hospital settings where the care is more expensive, increasing costs.

The Medicaid rolls also swell as more are eligible and strain state budgets as the federal government seeks to cut its share of Medicaid funding, Hefner said.

Cost and demand increase at the same time.

“You have a socioeconomic cascade that is occurring in those populations of people that are at risk or more vulnerable,” he said. “That could be adults and children. These are forces that are combining, rather than individual.”

This year could see the beginning of trends that play out in years to come, Hefner said.

“In terms of health care, no matter what, over the next 10 to 20 years, we’re seeing a fundamental retooling,” he said. “There’s a lot that is going to continue to shake out and change.”

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carcraft
25928
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carcraft 01/07/12 - 09:31 am
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ANNNND HEREE WE GOOOOO! If

ANNNND HEREE WE GOOOOO! If you like big corperations like GM, Southern Company (Georgia Power) and Wal Mart, you will love big corperation health care! Thank you Obumbler!

Techfan
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Techfan 01/07/12 - 09:58 am
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Nice to see the "penny

Nice to see the "penny medical" internet spammers up so early. Of course it's probably just computers scanning for any mention of health care.We've had big corporate health care and health insurers for decades. I seem to have missed car's complaints prior to Obama becoming president.

Techfan
6461
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Techfan 01/07/12 - 10:06 am
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For instance, in the 1990's,

For instance, in the 1990's, Fla. Governor Rick Scott (REPUBLICAN), as head of the giant mega health care corporation Columbia/HCA scammed medicare like crazy and received $1.7 billion in fines. For his crimes, Scott received a $300 million golden parachute and the Governorship of Fla. Great job Tea party.

allhans
23668
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allhans 01/07/12 - 12:04 pm
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Did car live in Fl when that

Did car live in Fl when that took place?

copperhead
1035
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copperhead 01/07/12 - 01:52 pm
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Have ANY of you read and

Have ANY of you read and understand the health care bill as passed? OR are you just following pelosi's lead "pass it to see what's in it"?

bjphysics
36
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bjphysics 01/07/12 - 02:01 pm
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How many Americans have read

How many Americans have read ANY bill they supported? Most support bills based on critiques from pundits they trust.

Patriot Act?

Gramm–Leach–Bliley Act?

carcraft
25928
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carcraft 01/07/12 - 06:33 pm
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Techfan- Your health care

Techfan- Your health care system brought to you by the same folks that spent $500 million on Solyndra and $3 billion on the Chevy Volt,(Chevy has recalled 8 thousand but has only sold 7 thousand, go figure, and they are recalling them because they catch fire) gee what could go wrong? Now Hospitals and health care providers are forced to merge to survive ( did you read the article?)! Not only that put private Doctors are going bankrupt!money.cnn.com/2012/01/05/smallbusiness/doctors_broke/index.htm Welcome to Obama care!

carcraft
25928
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carcraft 01/07/12 - 06:30 pm
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BJ Physics, I really wonder

BJ Physics, I really wonder how many people can understand Obama care? It referances other laws, changes sections of other laws and amends section of other laws. I listened as Mike Huckabee read sections of the bill and what a nightmare.

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