Obama Care, Bumps in the Road

Obama Care ApprovedAs a small business, Op4G covers 70% of our employees’ medical insurance costs through a group plan with Anthem Insurance. Typically, at this time of the year, our broker will reach out to us with quotes on competitive insurance carriers for our August 1st renewal. As a small business owner, I am concerned by articles stating that small businesses may see the price of medical insurance increase by 20% to 50% upon enactment of the reform.

Given my limited knowledge of the topic and its potentially significant effects, I thought it would be best to attend an open forum this week hosted by Centrix Bank Co-Founder Joe Reilly. The forum featured a discussion with Greg Walker, CEO of Wentworth Douglas Hospital (the #2 ranked hospital in NH) on the hospital’s preparation for the October 1st roll out of the Obama Care Small Business Health Options Program (SHOP) Exchanges.

During the discussion, Walker gave a brief overview of the Obama Care Act and strategic measures the hospital was implementing to manage patient care and meet their federal mandate of never refusing health service. He explained that the current challenge of a hospital is managing the cost of patient fees, as over 50% of the hospital charges are from uninsured individuals and most are not collectable. To balance these losses, a hospital is left with no choice but to charge more to insured individuals.

Walker then discussed health care models. He noted that while the majority of hospitals in America concentrate on treating sick people, forward thinking hospitals like Wentworth Douglas are changing their business model to focus on improving patient health and providing health care managers. Such managers can ensure patient compliance with doctors’ orders and prescriptions, thereby reducing the incidence of future hospital visits (e.g. from 11 to 1 annual visit for one elderly patient) and saving Medicare thousands of dollars. The Obama plan hopes to secure these savings through a managed patient care program that promotes and financially rewards hospital for keeping patients healthy.

In an effort to contain its costs, the Wentworth Douglas Hospital is currently weighing the cost control benefits of patient care through bundled payments. Other cost control consideration raised during the forum centered on unnecessary procedures for elderly individuals and “death with dignity” nationwide acceptance.

The forum offered a solid overview of healthcare approaches and cost containment in America. However, to my disappointment, Walker had very little information on the roll out of the SHOP exchange program and how the hospital will guide patients through the application process. In Walker’s words, it is as if he is “driving his car, knowing where he was going, but not being able to see clearly through the windshield”.

It looks like we are going to need a lot of straight road. Unfortunately, for small businesses there are going to be a lot of bumps along the way. So hold on!

Image Credit:
“Photo by Chuck Kennedy; U.S. Government Work”

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