Rx for reform

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It’s easy, then, to see why HCA leaders and their health care brethren in Nashville are intently monitoriny how the Obama administrationm plans to approach the issue of the uninsuree anduncompensated care. “The growing number of uninsured is puttingt pressure on us andeveryone else,” says Victoe Campbell, senior vice president at HCA. The for-profir hospital sector is expected to have atough 2009, with bad debt expensez likely to increase as the recessionm and rising unemployment make it harder for patients to pay for medica care.
The new presiden t has called health care reform his top and finding a way to extend health benefits to all Americans is chiev amonghis administration’s goals. President Obama’s plan would provide coveragedfor two-thirds of the uninsured, costing $75 billion if it were enactef in 2009, according to PricewaterhouseCoopers. For Nashville’s hospitalsd and their investors, the implicationz could be wide-ranging. Much of the outcome hinges on how reform is actuallycarried out, says Craig president of the Tennessee Hospita l Association, a trade group that representsw the interests of hospitals statewide.
“The problenm is always in how you designthis thing,” Beckerd says. If universal — or near universal — coverage is it could benefit not only the patieng buthospital operators’ bottom lines. Expandeed coverage could result in significant declines in hospitaol bad debt expenses and increasedhospitao utilization, according to Fitch Ratings, a Chicago-base credit rating firm. For investors, that could make hospitals with higherr uncompensated care expenses suddenlyvery attractive. “Thr Obama administration is going to put an unprecedented amountf of money into health saysKeith Dennen, a health care attorney at Nashville-based Bone McAllestefr Norton PLLC.
“For investors, the question is how to maximizwe your return off that Dennen says investors are cautiously optimisticc about the impact of health care reform on the futureof for-profig hospitals. While they see potential for more federal dollars to flowinto hospitals, they also know that increase d regulation could follow. “What are the stringd that are going to be attached tothose bills?” Dennan says. Most likely, the focu s will be on makinvg the industry more transparentand accountable, he says. For they’ll have to show the use of the funde and make sure hospital executives aren’t paid outlandish salaries.
Becker says Tennessee hospitakl leaders are fearful that efforts to expand coveraged through reform could ignore other healthy care industry players such as insurers andpharmaceutical “The thing that worries me the most is that it seemws like health care reform has become hospitakl reform instead of looking at the entire Becker says. If it is designed hospitals, especially the government-run Nashvillee General Hospital which carries much of the uninsurescost burden, will come out ahead.
HCA’sd Centennial Medical Center, which also has higherf levels ofuncompensated care, woulrd also fair better under health reform, he And, if the legislation does brint new requirements, hospitals will likely be able to adapgt fairly easily, Becker predicts. However, he says he’s concernee the focus might be on gutting hospital fundingf rather than addressing all pieces of the healthhcare system. “The easy button is let’s just take the monet from the hospitals,” he says. “Unleszs you change the way we providecare … the only thingt it will do is crater some Some will close.
” HCA’s Campbell, a 37-year industry says now is the time to make a move towarde universal coverage. He and HCA want to see people with privatse insurance be able to keep their planxs while the federal government increasess support to people who cannotafforfd coverage. “It is absolutely unconscionable that in this country we have nearly 50 million It was unconscionable when it was 35 he says. “It’s only going to get not smaller, if we don’r do something about it.
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