More than 200 people gathered at Overlook Medical Center to learn how the federal health care reform bill will affect patients, doctors and hospitals in the coming years, at a presentation and discussion with hospital leaders on Friday, March 2, 2012.
The presentation, “Health Care Reform and What it Means to You,” led by speakers Alan Lieber, president of Overlook Medical Center, and John Vigorita, MD, a Summit pediatrician, also addressed proactive steps being taken by hospitals to improve quality in care and reduce costs, such as Accountable Care Organizations (ACOs). The standing room-only crowd in Overlook’s Wallace Auditorium on Friday included residents of Summit and neighboring communities, as well as Atlantic Health System employees.
The health care reform bill passed by Congress and signed by President Obama in 2010 provides a “road map” for doctors, hospitals and patients for years to come, Lieber told the audience.
“Health care reform is arguably the most complex bill that’s ever been passed,” Lieber said.
The Patient Protection and Affordable Care Act, which became law March 23, 2010, will change the way millions of Americans access the health care system. Currently, 51 million Americans – including 1.3 million in New Jersey – don’t have medical insurance. The reform is expected to provide coverage to 32 million of those by 2019. It is estimated that 920,000 of New Jersey’s 1.3 million uninsured individuals will be covered.
Describing the current system in place, Lieber emphasized his view that reform was needed.
“The word of the moment in health care is ‘unsustainable,’” he said, adding that the 2010 bill was the first major overhaul of health care in the US since Medicare was established in 1965. The reform bill “created a road map for how Medicare is going to work over the next decade.”
Among the effects of the reform law, Lieber noted:
- All U.S. citizens and legal residents must have health insurance coverage or pay a penalty
- It will build on existing employer- and government sponsored insurance programs. Those who have health insurance coverage through their employer will have additional benefits in the short term
- It will include incentives for employer to offer insurance
- If someone is insured by Medicare, there are incentives to improve the coordination of care
- Every state must set up a health insurance exchange by 2014. New Jersey is currently developing our state’s exchange
- All hospitals will see reductions in payments. However, the new law will test ways to tie payment of hospitals and physicians to quality improvement, including programs to increase public reported quality data
Lieber said that regardless of how the changes would affect patients, “Overlook Medical Center is committed to improving the quality care we provide and providing cutting edge treatments,” he said.
Members of the community in the audience asked several questions, including how reform would affect coverage for the indigent and undocumented individuals; the difference between the federal reform law and the reform law in Massachusetts (the Massachusetts law did not include the provisions involving ACOs and bundling care, as the federal law did); and why the United States spends more to care for older Americans annually than European countries (Lieber and Vigorita replied that the US spends much more because it does more in later years to bring older people back to health than European countries).
In responding to a question about legal challenges to the insurance mandate in the reform law, Lieber said that the degree to which the mandate is vital to the legislation will affect the outcome of these challenges. However, he and Vigorita doubted that the entire law would be struck down. Lieber said that there might be some modifications to the law, but not a full repeal.
Dr. Vigorita added that if the bill is overturned, another bill that calls for the creation of ACOs is likely to follow shortly thereafter.
Noting that it helps patients, physicians and hospitals alike, Dr. Vigorita said of ACOs: “It’s basically a win-win for everyone.”
Dr. Vigorita spoke about the development of the Accountable Care Organizations and the application process for the Atlantic Health System Accountable Care Organization, LLC and the Optimus Healthcare Partners, LLC. Dr. Vigorita is chairman of the Optimus ACO.
ACOs aim to improve patient care quality, reduce costs, and streamline health care delivery, he said. ACOs are considered by many to be essential to the realization of national health care reform and are part of an overall vision of better and more affordable care for Medicare beneficiaries and heightened efficiency among physicians, hospitals, and insurers.
“I love that this room is packed today,” Dr. Vigorita said. “None of these changes are going to take place without patient engagement. This is a good sign, this is a great sign.”
“I thought the presentation went very well,” said Lorenzo Corsi, a Union County resident. “It gave me a new perspective on the health care legislation, and it gives me the feeling that if the Supreme Court decision comes down, the whole thing isn’t going to be abandoned.”
“It’s also very reassuring that the health industry is trying to reduce costs through ACOs as well as patient, hospital and physician coordination,” Corsi said.
The presentation can be viewed online from HomeTowne Television (Comcast Channel 36 and Verizon Channel 33): Understanding Healthcare Reform