The Obama administration took a major step toward the implementation of the Affordable Care Act (ACA) with the release of a series of proposed rules outlining essential health benefits, market reforms and wellness programs Nov. 20.
Even prior to the release, health care industry representatives from across the state indicated in conversations with the Business Journal that President Obama’s crowning achievement does not nearly go far enough in reigning in the cost of health care, with several suggesting the issue would require further legislative changes.
“If we realize the promise of health care reform, we’re going to have millions more Americans with access to health care,” said Bridgeport Hospital CEO William M. Jennings. “That is a great thing, a wonderful thing … the problem is, I’m still unsure of how we’re going to get paid.”
With reimbursements already on the decline, Jennings said health care providers have no choice but to maximize efficiency with an eye on cutting costs while taking care to ensure that any changes don’t compromise the quality of care.
“Continuing to focus on ways to reduce our costs is not an option – it’s a strategic imperative – and there are ways to do that,” he said.
The Yale New Haven Health System, of which Bridgeport Hospital is a member, is in the process of implementing an electronic medical records system, which Jennings said is a “critical step” as providers gear up for an increase in patients once the ACA is fully implemented.
Jennings said the members of the Yale New Haven Health System must also work to leverage their combined resources and focus on maximizing clinical integration between each hospital and other providers serving their respective patients and communities.
Despite all that, Jennings said the possibility of cutbacks to reimbursements “poses a serious threat” to hospitals and doctors.
Representatives of health insurance providers Aetna Inc., based in Hartford, and Cigna Corp., based in Bloomfield, said the ACA failed to address the rising cost of health care.
“Full implementation of the law will have a dramatic effect on insurance rates and that’s an issue that needs to be addressed,” said Aetna spokeswoman Susan Millerick.
Cigna spokesman Jon Sandberg said the company’s priority “has always been ensuring Americans have access to quality, affordable health care.” However, he acknowledged concerns that “the ACA does not adequately address the rising health care costs.”
Despite measures built into the ACA that hold carriers accountable for premium increases that exceed 10 percent and that require they spend 80 percent of any premium income directly on health care and quality improvements, talk of steep rate increases have business owners anxious.
Chris Peck, CEO of Creative Benefit Planning (CBP), a Stamford-based benefits management and consulting firm, said the cost of health care has some business owners seriously considering whether they want to remain in business.
“I think it’s becoming one more thing they can think about,” Peck said. “It’s enough of a headache and enough of a cost to start playing into the mind of a business owner, who’s saying, ‘I didn’t come into the business to be an administrator of benefits.’”
The burden on business owners is becoming more onerous, Peck said. “It’s going to start weighing in as more of a factor I think when the business owner is thinking about those things. It might be the straw that breaks the camel’s back.”