09 20 11 medical group managers association ppaca presentation

7/30/2019 09 20 11 Medical Group Managers Association PPACA Presentation

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Healthcare Reform Briefing

Presented to the

NorthLakeAssociation of Medical

Managers

September 21, 2011

by James Person


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James Person is the Public Affairs Specialist for St. Tammany ParishHospital. He is responsible for analyzing the effects of federal, state andlocal legislation and regulations on the hospitals ability to deliver world-class healthcare close to home. He also assists with external and internalcommunication efforts.

Person previously served on Capitol Hill as a legislative aide for two Members ofCongress and a prominent public policy think tank. He also managed and workedon congressional election campaigns in North Carolina, Wisconsin and Louisiana.

He is a native New Orleanian and an alumnus of Mandeville High School andLouisiana State University- Baton Rouge where he received a Bachelor of Arts

degree in Mass Communication. Currently, he attends the University of NewOrleans where he is earning a Master of Business Administration degreeconcentrating in finance. He lives in Mandeville with his wife and two sons.

Biography


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Super Committee

Whats Left to Do

Outlook

Presidents Proposals

Healthcare Reform

Overview


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Super Committee


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Stage 1- Budget Control Act Immediate budget reductions of $917 B

Super Committee


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Stage 1- Budget Control Act

Immediate budget reductions of $917 B Extends debt limit by $900 B

until Feb/March

Super Committee


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Immediate budget reductions of $917 B

Extends debt limit by $900 Buntil Feb/March

No cuts to Medicare or Medicaid

Super Committee


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Immediate budget reductions of $917 B

Extends debt limit by $900 Buntil Feb/March

No cuts to Medicare or Medicaid

No tax increases

Super Committee


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Stage 2-

Find $1.5 T in deficit reductionrecommendations by Thanksgiving

Super Committee


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Stage 2


If a deal is reached:

Up-or-down clean vote in Congress

Super Committee


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Stage 2


If a deal is NOT reached:

Sequestration

Super Committee


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Sequestration

$1.2 T in cuts

Super Committee


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Sequestration

$1.2 T in cuts

Automatic, across-the-board

Super Committee


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Sequestration

$1.2 T in cuts


Cuts $123 B from Medicare

Super Committee


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Sequestration

$1.2 T in cuts Automatic, across-the-board


Medicaid exempt

Super Committee


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Sequestration

$1.2 T in cuts



Medicaid exempt

If deal


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Sequestration

Some groups may actually prefer this!

Super Committee


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October 14: Congressional committee recs due

Important Dates


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November 23: Super committee votes

Important Dates


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November 23: Super committee votes

December 23: House and Senate votes

Important Dates


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Medicaid ($100 B)

Options


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Medicaid ($100 B)

No more provider taxes

Options


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Medicaid ($100 B)

No more provider taxes

Blended FMAP rates

Options


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Medicare

Options


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Medicare

IME cuts ($15 B)

Options


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Medicare IME cuts ($15 B)

Eliminate bad debt payments ($15-$30 B)

Options


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Medicare

IME cuts ($15 B)


Others ($69-$71 B)

Options


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Medicare

IME cuts ($15 B)


Others ($69-$71 B) Expansion of IPAB

Options


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Other Increase retirement age ($125 B)

Means-testing ($38 B)

Medicare copay reform andincreases ($110 B)

Medigap restrictions ($53 B) Home health copays ($40 B)

SNF copays ($50 B)

Options


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Expiring tax provisions

AMT patch

R & D tax credits

Accelerated depreciation

Whats Left to Do?


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Expiring tax provisions

AMT patch

R & D tax credits

Accelerated depreciation

Medicare DOC FIX !!!! ($300 B)

Whats Left to Do?


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MedPAC doc fix proposal

Doc Fix


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Cut specialist payments 6%

Doc Fix


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MedPAC doc fix proposal Cut specialist payments 6%

Keep PCP rates flat

Doc Fix


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Cut specialist payments 6%

Keep PCP rates flat

Paid for with cuts to otherhealthcare sectors

Doc Fix


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Outlook


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Outlook


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Outlook


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Outlook


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Reduce payroll taxesIncrease spending by $447 B

Jobs Proposal


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Reduce payroll taxes

Increase spending by $447 B

paid for with

Jobs Proposal

b l


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Increase spending by $447 Bpaid for with

Tax increases andlimiting itemized deductions

Jobs Proposal

b l


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Increase spending by $447 Bpaid for with

Tax increases andlimiting itemized deductions

Jobs Proposal

fi i d i l


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Deficit Reduction Proposal

D fi i R d i P l


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D fi i R d i P l


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Save $3.5 T over 10 years


D fi i R d i P l


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$320 B from Medicare and Medicaid


D fi it R d ti P l


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$320 B from Medicare and Medicaid $248 B from Medicare

$73 B from Medicaid


D fi it R d ti P l


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$320 B from Medicare and Medicaid

$248 B from Medicare

$73 B from Medicaid

OMB baseline assumes doc fix?!


D fi it R d ti P l


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No cuts to Social Security

No structural changes to Medicare No benefit changes


D fi it R d ti P l


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Blended FMAP

MOE

No provider taxes ($26 B)

Increase


D fi it R d ti P l


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MedPAC recommendations

o

IME cutso Bad debt payment cuts

o Medical imaging utilizationrate cuts


D fi it R d ti P l


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IPAB

PPACA:Medicare spending

per beneficiary > GDP growth + 1%


Deficit Red ction Proposal


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IPAB

Obama deficit reduction:Medicare spending

per beneficiary > GDP growth + 0.5%




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IPAB

Obama deficit reduction:Medicare spending





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IPAB

Obama deficit reduction:

Medicare spending

per beneficiary > GDP growth + 0.5%Sequestration




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IPAB

Obama deficit reduction:

Medicare spending


Sequestration = Provider CUTS


Healthcare Reform


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Healthcare Reform

Healthcare Reform


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Healthcare Reform

Policy
http://www.mgma.com/index.aspx


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MGMA PrinciplesFix the Medicare physician payment system

Simplify administrative transactions

Medical liability reform

Expand coverage

Improve quality and safety

Promote adoption of HIT

Policy

Policy
http://images.google.com/imgres?imgurl=http://www.law.columbia.edu/ipimages/Information_technology/images/checkmark.png&imgrefurl=http://www.law.columbia.edu/it/&usg=__jX0eg2MojVqURzW7Q-niNk_4f6o=&h=318&w=364&sz=36&hl=en&start=1&itbs=1&tbnid=7xi1LVPsRlhOgM:&tbnh=106&tbnw=121&prev=/images?q=check+mark&hl=en&safe=active&sa=G&gbv=2&tbs=isch:1http://images.google.com/imgres?imgurl=http://www.law.columbia.edu/ipimages/Information_technology/images/checkmark.png&imgrefurl=http://www.law.columbia.edu/it/&usg=__jX0eg2MojVqURzW7Q-niNk_4f6o=&h=318&w=364&sz=36&hl=en&start=1&itbs=1&tbnid=7xi1LVPsRlhOgM:&tbnh=106&tbnw=121&prev=/images?q=check+mark&hl=en&safe=active&sa=G&gbv=2&tbs=isch:1http://images.google.com/imgres?imgurl=http://www.law.columbia.edu/ipimages/Information_technology/images/checkmark.png&imgrefurl=http://www.law.columbia.edu/it/&usg=__jX0eg2MojVqURzW7Q-niNk_4f6o=&h=318&w=364&sz=36&hl=en&start=1&itbs=1&tbnid=7xi1LVPsRlhOgM:&tbnh=106&tbnw=121&prev=/images?q=check+mark&hl=en&safe=active&sa=G&gbv=2&tbs=isch:1http://images.google.com/imgres?imgurl=http://www.law.columbia.edu/ipimages/Information_technology/images/checkmark.png&imgrefurl=http://www.law.columbia.edu/it/&usg=__jX0eg2MojVqURzW7Q-niNk_4f6o=&h=318&w=364&sz=36&hl=en&start=1&itbs=1&tbnid=7xi1LVPsRlhOgM:&tbnh=106&tbnw=121&prev=/images?q=check+mark&hl=en&safe=active&sa=G&gbv=2&tbs=isch:1http://www.mgma.com/index.aspxhttp://www.mgma.com/index.aspx


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MGMA Statement

MGMA cannot support this final legislation

HCR fails to address SGR and payment fix

Independent Payment Advisory Board (IPAB)

No meaningful federal medical liability reform

Cuts to the technical component of imaging services

Physician-self referral ban

Administrative simplification not fully realized

Policy
http://www.mgma.com/index.aspx


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Expanding Coverage to 32 Million

158 million

25 million

What Would Happen Under Reform

Source: Congressional Budget Office


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Coverage: Insurance Exchanges

In 2014, all individuals will be required to obtain coverage orface a penalty.

Individuals can purchase coverage from newly createdinsurance exchanges.

Federal help for some individuals to pay for insurance.


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Coverage: Insurance Exchanges


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Questions

?

09 20 11 medical group managers association ppaca presentation

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