Industry group: Health care reform still a mystery

2013-03-10T06:00:00Z Industry group: Health care reform still a mysteryBy Vanessa Renderman vanessa.renderman@nwi.com, (219) 933-3244 nwitimes.com

INDIANAPOLIS | As health care reform unfolds in the United States, people associated with the industry still have unanswered questions.

The Healthcare Businesswomen’s Association Indiana Chapter recently hosted a question-and answer-session in Indianapolis for its members, with panelists addressing some of the common queries. 

"A lot of us in this room have no idea how the ACA (Affordable Care Act) affects us," moderator Todd Vare started the discussion.

He and HBA Indiana Chapter President Dawn Lang read questions submitted by the group. They asked for definitions of terms, about employer concerns, about cost and impact. Panelists answered what they could but admitted there are still unknowns.

State Rep. Ed Delaney, D-Indianapolis, likened it to the Y2K panic more than a decade ago.

"That's nothing compared to this," he said.

Between Oct. 1, 2013, when open enrollment for the health insurance marketplace begins, and Jan. 1, 2014, when the individual insurance mandate goes into effect, there will be heightened confusion.

"It will probably take us a year or two to get it all calmed down," Delaney said.

Logan Harrison, Chief Deputy Commissioner for Health, Public and Legislative Affairs for the state of Indiana, said the government will need to conduct a massive public relations campaign leading up to open enrollment. "Navigators" and "assisters" will serve as education facilitators, helping guide people through the insurance process in regards to the ACA.

Panelists were asked their opinion on how the ACA will impact insurance premiums. 

"I do believe that there is going to be an increase," said Vicki Perry, CEO of Advantage Health Solutions. "The reality is, you can't add all those people and not expect cost to go up."

Cindy Adams, chief nursing officer of Community Health Network, said health care providers will need to address looming nursing and physician shortages.

She said shortages will cause other medical professionals, such as paramedics and licensed nurse practitioners, to work to "the top of their license." In other words, they will be asked to perform the maximum allowed level of care as they are able.

Providers may train workers with non-medical backgrounds to take over some tasks. To an extent, that is already being done when family members become caretakers and are taught how to perform certain procedures on loved ones, Adams said.

On the pharmaceutical side, a key consideration of the ACA impact is how to continue providing innovation, said J. Carmel Egan, Vice President of Portfolio Project Management, R&D for Eli Lilly and Co.  and HBA Indiana President-Elect.

An audience member asked for the definition of an accountable care organization (ACO). The U.S. Department of Health & Human Services defines it as a group of health care providers who give coordinated care and chronic disease management to improve the quality of care for patients. Its payment is tied to achieving health care quality goals and outcomes that result in cost savings.

But Adams said those in health care are waiting to find out what some of the terms truly mean.

"We're all waiting for those definitions to crystallize," she said.

Perry said it is a patient-centric approach, with the ACA mandating providers to manage their patients' care.

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