Health Care Reform

Uploaded by ECImedTV on Oct 25, 2010
Hello, I am Dr. Robert Williams, Chairman of ECI
2010 has been an historic and tumultuous year for American healthcare. On March 23, 2010, after a prolonged and highly partisan process, President Obama signed the Patient Protection and Affordable Care Act, known simply as ACA.
Although the ACA will not be fully implemented for several years, this law will have a profound effect on our healthcare system, including emergency medicine and hospitalist services.
So, what are the implications of healthcare reform? (slide?)
• significant insurance reform,
• expanded coverage to more than 30 million people,
• a huge expansion of Medicaid, which is a joint federal/state program,
• an individual mandate -- meaning that everyone must have health insurance or pay penalties,
• higher taxes on the wealthy,
• plus, over 2700 pages of details, yet to be determined.
There are a several important details not addressed by this legislation. These include: (slide?)
• universal coverage --23 million people remain uninsured. Most of these people are undocumented immigrants.
• also, meaningful cost control,
• tort reform, and
• a clear understanding of the long-term effects of the legislation, or
• a permanent fix to the physician compensation formula.
The ACA was not a quick fix, and paying for health care reform remains a daunting task. Under the new law, financing will come primarily from:
• a 500 billion dollar cut in the growth of Medicare spending,
• tax increases on the wealthy, and
• substantial new taxes on drug companies and medical equipment suppliers.
These resources will support Medicaid funding on a national level, but many states will struggle to pay their portion of this program expansion. State funding issues are especially relevant to emergency medicine. Recent articles in the Journal of the American Medical Association and from the CDC report huge increases in ED volumes, which reached as high as 124 million in 2008. Most of this growth is attributed to more visits from Medicaid patients.
These types of challenges leave us with no permanent resolution to the physician compensation formula, known as the SRG. In 1998, all physicians were scheduled to receive a 21% cut in Medicare reimbursement effective January 1st of this year. Fortunately, as they have for the past few years, the cuts have been put on hold. The pending cuts represent an estimated $370 billion in costs that were not included in the $1 trillion cost estimates for healthcare reform. This will continue to compound if the physician compensation issue is not resolved and will reach an estimated $500 billion by 2015.
There is a lot we do not know and understand about the future implications of this new law, but there are things we know that will affect all of us at ECI and HCI.
In coming years, there will be an increased focus in several important areas: (slide?)
• higher quality
• improved efficiency
• increased accountability and verification, and
• better risk management.
Since 1972, our organization has remained committed to achieving all of these ideals. As a result, we have created a wealth of highly innovative programs that continue to benefit practitioners across the country.
This organization has the skills, expertise, and commitment required to meet the many new challenges of health care reform.
As a new day dawns in American healthcare, all of us at ECI and HCI are awake, energized, and ready to go!
Thank you.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at
http://atlanticfinancial.us/ or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.