Hospitals wary of GOP health bill’s effect

Some say the plan to replace Obamacare puts facilities’ finances in such jeopardy that they could close

The Republican plan to replace Obamacare could have a dire impact on hospital finances, some health care experts warn, creating serious concerns about patient safety and health care quality.

Josh Sharfstein, a pediatrician and former top health official for the city of Baltimore and the state of Maryland, says the impact of the Affordable Care Act ( ACA) goes far beyond expanding health insurance coverage to millions of Americans so they can get the treatment they need. That insurance reimbursement also helps keep hospitals afloat, he says.

“It’s underappreciated how much the ACA has focused the health care system on delivering a higher quality of care. This could easily be lost,” says Sharfstein, now a professor and associate dean at the Johns Hopkins Bloomberg School of Public Health. “The consequences of hospitals being under financial distress include closing all together, stopping particular services that may be very necessary to the community and struggling to maintain quality of care.”

All of the major hospital groups, including the American Hospital Association and those representing children’s hospitals and psychiatric hospitals, came out against the new legislation last week. They cited the number of low income people who would become uninsured because of changes in the Medicaid program, as well as cuts in subsidies to those with ACA individual plans.

However, some suggest hospitals are being unduly alarmist about the effect the proposed Obamacare replacement law — the American Health Care Act — could have on hospitals’ ability to provide quality care.

“It’s an attempt to get more money from the taxpayers through this legislation,” says James Gelfand, senior vice president for health policy at the ERISA Industry Committee, which represents major employers on benefits issues.

Joe Kiani, founder and CEO of the medical technology company Masimo, founded the Patient Safety Movement Foundation in 2013 to prod hospital systems into reducing the number of preventable injuries and deaths through collaboration and public commitments. His mission was buoyed by the ACA.

“When we talk about 125,000 lives being saved because of the ACA, we’re completely talking about the very proactive provisions of the ACA” that helped boost quality and safety, says Kiani.

For example, the ACA established penalties against hospitals when Medicare patients have to be readmitted within 30 days of a procedure. It also beefed up Medicare penalties against hospitals that have “never events,” those serious, preventable hospital incidents like pressure ulcers that should never happen.

Since the foundation’s launch, the number of deaths it says have been prevented when hospitals met safety commitments has increased from 60 in 2013 to an estimated 33,500 lives saved in the U. S. in 2016.

These numbers also reflect the doubling of safety commitments every year, At the foundation’s fifth annual summit last month, for example, 3,526 companies made safety commitments, up from 1,624 last year.

The quality and safety of hospital care are top priorities among the ERISA Industry Committee’s employer members, Gelfand says. In January, the committee’s board set as a top priority the movement away from health care that pays for the number of treatments instead of the quality of care.

The ACA’s overarching goals of improving health and reducing costs make the safety foundation’s founder hopeful that whatever replaces the law retains its focus on safe, high- quality care.

“I’m not aware of one patient safety process that doesn’t reduce the out of pocket cost to society,” says Kiani. “These things just make so much sense that you scratch your head and say, ‘ Why isn’t everyone doing it?’ ”

“It’s underappreciated how much the ACA has focused the health care system on delivering a higher quality of care. This could easily be lost.”

“When we talk about 125,000 lives being saved because of the ACA, we’re completely talking about the very proactive provisions of the ACA” that helped boost quality and safety.

Hospitals’ reaction to the American Health Care Act is “an attempt to get more money from the taxpayers through this legislation.”

JOHNS HOPKINS UNIVERSITY BLOOMBERG SCHOOL OF PUBLIC HEALTH Josh Sharfstein, former Maryland Secretary of Health, is now director of the Bloomberg American Health Initiative at Johns Hopkins University and a professor at the university’s school of public health.

ERISA INDUSTRY COMMITTEE James Gelfand is senior vice president for health policy at the ERISA Industry Committee, which represents large U. S. employers.

PATIENT SAFETY MOVEMENT FOUNDATION Joe Kiani, founder and CEO of the medical technology company Massimo, founded the Patient Safety Movement Foundation in 2012.