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Policy & Regulation News

Hospitals, Health Systems Eye Financial Snags in ACA Repeal

A looming federal ACA repeal and replace strategy has many hospitals and health systems concerned about healthcare costs.

Healthcare costs of ACA repeal

Source: Thinkstock

By Kyle Murphy, PhD

- In identical letters to the Trump Administration and Congress, the American Hospital Association and other state and regional associations are urging members of both branches of the federal government to continue working on legislation to improve care access, quality, and cost.

“We understand the ACA needs change and hospitals and health systems have offered solutions to fix it, and we are committed to working with you on legislation that maintains coverage and improves America’s health care system through patient-centered care,” they explain. “Our shared goal is to ensure continued high-quality health care for our patients in urban and rural communities alike.”

In the letters, AHA and others lay out six top priorities for federal officials to consider in debating a repeal and replacement of the Affordable Care Act.

The first focuses on maintaining coverage for current beneficiaries under ACA.

“If the ACA is to be repealed, the potential repeal and replace should be done simultaneously, and ensure that the 22 million people receiving coverage continue to receive adequate coverage,” the letter states.

Second, the organizations representing hospitals and health systems across the care continuum urge the Trump Administration and Congress to avoid negatively impacting hospital and health system resources in their approach to an ACA repeal and replacement.

“If repeal and replace cannot be accomplished simultaneously, the reductions to hospitals and health systems included in the ACA should be restored to ensure there are sufficient resources to provide care to the uninsured,” they recommend.

Additionally, AHA and others warn against reductions to hospitals and health systems during the process of repealing and replacing the ACA. “Further reductions to hospitals and health systems should not be considered during either reconciliation or the replace debate,” they add.

The hospital organizations also seek to avoid a breakdown in federal-state partnerships responsible for enabling consumer and provider access to health coverage.

“Any Medicaid restructuring should continue the federal-state partnership that ensures beneficiaries and providers continue to have access to high-quality health care coverage, provides sufficient funding, and treats expansion and non-expansion states in an equitable manner,” they warn.

At the same time, AHA and others call for future regulatory reform to take into account the federal red tape negatively impacting their operations.

“Significant regulatory reform to address the burden faced by hospitals and health systems needs to be implemented by both the legislative and executive branches,” they contend.

Lastly, the group of hospital and health system associations emphasizes the need for federal incentives that promote care coordination and integration.

“Continued efforts to improve the health care system and make care more affordable should be supported by moving to fee-for-value based payment that provides incentives for clinically integrated coordinated care,” they write.

AHA was part of a 121-member alliance of healthcare organizations recently writing President Donald Trump and Vice President Mike Pence to ensure continued federal support for value-based care and MACRA implementation.

The main focus of the letter to the Trump administration was to enumerate ten principles the alliance of healthcare organizations considers essential to achieving a “modernized, sustainable healthcare system.”

Similarly, the American Medical Group Association (AMGA) wrote last week to House Speaker Paul Ryan (R-WI) to recommend several key improvements deemed necessary for ensuring a successful MACRA implementation of value-based care models.

Namely, the trade association called on Congress to enable providers to have access to claims data, to make data standardization between payers and providers a national priority, and to give providers access to the financial capital necessary to implement value-based care.

While little more than a week has passed since the transfer of power within the Executive Branch, that time has fueled plenty of concern about the fates of both ACA and MACRA.


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