Doctors, nurses, insurers, hospital officials, patient advocates and health policy experts forecast changes on the regional horizon at a daylong conference at the law school on Oct. 22.
“This is an issue of tremendous importance to the Philadelphia region; our economy is heavily dependent on health care,” said Robert Field, a professor of law and professor of health management and policy at the School of Public Health who organized the conference with Barry Furrow, professor of law and director of the law school’s Health Law Program. “The train is moving down the tracks, and we want to see what people are doing to get ready for it.”
Pennsylvania used federal funds allocated through the new law to create a high-risk pool for thousands of uninsured patients and aims to launch a Health Information Exchange, a secure statewide network for sharing patient information among health care providers, said Ann Torregrossa, who heads the Governor’s Office on Health Care Reform.
The exchange will reduce redundant tests and procedures while improve patient safety, Torregrossa said, pledging that “this is going to make a difference in how health care is delivered.”
Meridian Health Vice President Russ Molloy and Catholic Health East CEO Judith Persichilli said reforms will have a significant impact on hospitals, which will be reimbursed for quality of treatment, rather than number of procedures performed.
Hospitals have already begun to consolidate and merge into networks, Molloy said, since the law’s push toward electronic record-keeping carries too high a tab for stand-alone facilities.
“What we need are a host of models,” said Roberta Waite, a professor at the College of Nursing and Health Professions. Waite pointed to Drexel’s 11th Street Family Health Services Center, which offers an integrated approach to prevention that both involves and serves the community, as a model that can meet the goals of reform.
Dr. Richard Baron, the past president of the American Board of Internal Medicine and an internist with Greenhouse Internists, said health reforms could have a major impact on academic health centers, which have historically focused on treating complex cases and handling them in high volume.
The new law encourages academic health centers to focus more on delivering proven interventions and less on the costly undertaking of testing new ones, said Dr. Richard Wender, chairman of the Department of Family and Community Medicine at Jefferson Medical College.
Money will soon be on the table to promote new collaborations between doctors and hospitals that aim to improve patient care while reducing costs, said Dr. David Grande, a professor at the University of Pennsylvania School of Medicine.
“This is a watershed time for prevention and public health,” said Marla Gold, dean of Drexel’s School of Public Health, which co-sponsored the conference. “This is an incredible piece of legislation. At least we are on our way.”
Yet in Philadelphia, a provision of the law could actually hamper the city’s existing menu labeling ordinance, which is more detailed than the federal requirement, said Dr. Giridhar G. Mallya, who directs policy and planning for the city’s Health Department. Philadelphia is seeking a waiver to preserve its own rules for disclosing the fat, carbohydrate and sodium content of meals served by restaurant chains, Mallya said.
One of the most notable changes from the new law is the mandate that individuals purchase health insurance if it is not provided by an employer. The insurance will be available through an exchange, where individuals will be charged based on their income.
“We’re getting rid of the concept of actuarial fairness, where it’s discriminatory to charge a health person and a sick person the same price,” said Tom Baker, the William Maul Measey Professor of Law and Health Sciences at the University of Pennsylvania Law School.
The health exchange the state plans to create for individuals must function smoothly and involve consumers in its governance, said Laval Miller-Wilson, executive director of the Pennsylvania Health Law Project.
“If it’s not a positive experience, it will sour people,” Miller-Wilson said.
Mark T. Bullock, senior vice president of Mercy Health System, said the new law is placing a whole new set of regulatory hurdles on the already-complex health system.
Those regulations give law enforcement officials additional resources and teeth with which to root out fraud and promote patient safety, Assistant U.S. Attorney for the Eastern District of Pennsylvania Virginia A. Gibson said.
While the full impact of the reforms is impossible to predict, the need for change is undeniable, said Independence Blue Cross Vice President and General Counsel Richard Levins.
“The current model cannot sustain itself,” Levins said, noting that the U.S. now spends 17 percent of its Gross Domestic Product on health care. “The costs are out of control.”
Watch the proceedings here: http://media.irt.drexel.edu/mediasite/SilverlightPlayer/Default.aspx?peid=a077114cf98141dfa1df605a008a66a11d