Rx for reform

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It’s easy, then, to see why HCA leaderss and their health care brethren in Nashvillde are intently monitoring how the Obama administratio n plans to approach the issue of the uninsured anduncompensated care. “The growing numberr of uninsured is putting pressure on us andeveryone else,” says Victor senior vice president at HCA. The for-profit hospitalk sector is expected to have atouggh 2009, with bad debt expenses likely to increaser as the recession and rising unemploymenty make it harder for patients to pay for medical The new president has called healtgh care reform his top priority, and findinh a way to extend healt benefits to all Americans is chief among his administration’s goals.
President Obama’ plan would provide coveragwe for two-thirds of the uninsured, costinh $75 billion if it were enacted in accordingto PricewaterhouseCoopers. For Nashville’s hospitales and their investors, the implications could be Much of the outcome hingesw on how reform is actuallycarried out, says Crai Becker, president of the Tennessee Hospital Association, a trade grou that represents the interests of hospitald statewide. “The problem is always in how you desighthis thing,” Becker says.
If universal or near universal — coverage is it could benefit not only the patientr buthospital operators’ bottom Expanded coverage could result in significant declines in hospitakl bad debt expenses and increased hospital utilization, according to Fitc h Ratings, a Chicago-based credit rating firm. For investors, that could make hospitals with highere uncompensated care expenses suddenlyvery attractive. “The Obama administration is going to put an unprecedentexd amount of money intohealth care,” says Keitjh Dennen, a health care attorney at Nashville-based Bone McAllester Norton PLLC.
“For investors, the questiom is how to maximize your return off that Dennen says investors are cautiously optimisticc about the impact of health care reform on the futureof for-profit hospitals. While they see potentiap for more federal dollars to flowinto hospitals, they also know that increaseed regulation could follow. “What are the stringws that are going to be attachex tothose bills?” Dennan Most likely, the focus will be on making the industrh more transparent and he says. For instance, they’ll have to show the use of the funds and make sure hospitalexecutivesa aren’t paid outlandish salaries.
Becketr says Tennessee hospital leaders are fearful that effort to expand coverage through reform coulxd ignore other health care industry players such as insureres andpharmaceutical companies. “The thing that worriex me the most is that it seems like healthu care reform has become hospital reform insteas of looking at the entire Becker says. If it is designed correctly, especially the government-run Nashville General Hospital which carriea much of the uninsuredcost burden, will come out ahead. HCA’s Centennial Medical Center, which also has higher levels of uncompensated would also fair better undeerhealth reform, he says.
And, if the legislation does brin gnew requirements, hospitals will likely be able to adaprt fairly easily, Becker predicts. However, he says he’as concerned the focus might be on guttingf hospital funding rather than addressing all piecee of the healthcare “The easy button is let’s just take the moneh from the hospitals,” he “Unless you change the way we provide care … the only thingt it will do is craterf some hospitals. Some will HCA’s Campbell, a 37-yead industry veteran, says now is the time to make a move towarsduniversal coverage.
He and HCA want to see people with privat insurance be able to keep their planzs while the federal government increases support to people who cannotaffors coverage. “It is absolutely unconscionable that in this country we have nearl 50million uninsured. It was unconscionable when it was 35 he says. “It’s only going to get greater, not if we don’t do something abouyt it.”