Mercy CEO: Health law a 'step forward'

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Friday, June 29, 2012
— Janesville's two largest health care and insurance providers took Thursday's decision upholding President Barack Obama's health care overhaul in stride, saying the law is not perfect but it moves the nation in the right direction.

That's because Wisconsin is a national leader in health care integration and efforts to increase access to quality care at reduced costs, they said.

"We haven't been sitting around waiting for the law to be overturned constitutionally," said Rich Gruber, vice president of community advocacy for the Janesville-based Mercy Health System. "In Wisconsin, hospitals and insurers want first and foremost to make sure they are doing their part to meet the expectations of the law, particularly in terms of access, quality and cost."

Setting political arguments aside, Gruber and Craig Samitt, president and chief executive officer of Dean Health System, said the Affordable Care Act is a step in the right direction.

"The court's decision suggests that we're continuing to move forward, not backward," Samitt said. "The legislation is not perfect, but it's a step forward because it improves access to health care."

Samitt said the law is a platform for additional improvements and modifications toward a national goal of improving quality while reducing health care costs.

Gruber said the fact that the Supreme Court didn't overturn a law providers and insurers have been preparing for for more than two years would keep organizations' momentum going.

He knows the debate will continue as the presidential campaign heats up.

"Historically, however, once you have this type of social legislation upheld, it's incredibly difficult to undo," he said. "I hope the apple cart doesn't get completely turned over because there are a lot of good things in it."

Accountable care

One of the best elements, Gruber said, is that more Americans will get access to health care.

"It's vitally important that that care is managed and coordinated, which is also part of the law," he said, referring the law's creation of accountable care organizations, groups of doctors, hospitals and other providers who work together to give coordinated, high-quality care to their Medicare patients.

The goal of such organizations is to ensure that patients get the right care at the right time while avoiding duplications in services and preventing medical errors.

When an accountable care organization delivers high quality care and spends health care dollars more wisely, it will share in the savings it achieves for the Medicare program.

"What's in the law are things that we've been doing since the early 1990s," Gruber said. "We think we've invented the ideal profile of an accountable care organization, and we'll continue to make refinements."

Samitt said delivering higher quality care at lower costs to more people—the basis of Obama's law—is something Dean and its partner, SSM Health Care of Wisconsin, have been focused on for the last decade.

"Dean's focus and strategy is the same today as it was yesterday," Samitt said Thursday. "It would have been that way regardless of the Supreme Court decision.

"Our commitment to our patients and communities remains to be to deliver the highest quality care as cost effectively as possible."

Steve Brenton, president of the Wisconsin Hospital Association, said health care reform is not new in Wisconsin.

Wisconsin hospitals, he said, have been quietly transforming health care by focusing on quality improvement and making innovative changes in both the delivery of and payment for health care.

"Health reform is already well under way in Wisconsin, and our journey down this path will continue, and would have continued, regardless of how the court ruled," he said. "Health care leaders have been reforming care in our state to improve quality, moderate costs, expand access and raise the value of health care in Wisconsin."

State providers already are developing new systems of care that improve quality and reduce cost, Brenton said. Hospitals are working with insurers to develop new payment models in health care, moving away from volume-driven, unit pricing toward bundled payments that are tied to specific outcomes.

"We're not going to be doing anything different than what we have been doing," Samitt said. "We're staying the course and continuing to reform health care from Wisconsin, not from Washington."

Employer perspective

Cheryl DeMars is the president and chief executive officer of The Alliance, an employer-owned and directed not-for-profit cooperative that helps companies—including several in Rock County—manage their health insurance.

She said her organization has been working with employers to better understand the law, particularly how it relates to metrics on quality and cost.

"The Affordable Care Act is now the law of the land," she said. "What it hopefully does is provide a clearer path to what we've been working on for some time."

Employers, she said, are concerned about improving the quality of health care their employees receive and making sure its delivered in a cost efficient manner.

While that's a goal of the law, DeMars said employers are interested in the structure of the law and how it will make quality and cost metrics as transparent as possible.

Employers, she said, also are looking for guidance on a variety of the law's components that have not been well publicized.

"We need clarity and guidance on the rules and regulations for some of the things that have not been released yet," she said.

Examples, she said, are clear definitions on how average 30-hour workweeks will be calculated and how employees will be counted under the provision that by 2014 small companies with 50 or more full-time employees would need to provide insurance coverage or face expensive fines.


"Today's ruling by justices appointed by presidents of both parties is an independent legal judgment. It is now time to come together and make this work.

"I disagree with those who want to rip up the decision of an independent court and start over. I am committed to continuing my work across party lines to make reform work, and if there are bipartisan solutions that strengthen reform, we should work together to move them forward. ...

"I believe middle class families should have the peace of mind knowing they will have access to quality, affordable health care, regardless of any preexisting condition."—Rep. Tammy Baldwin, D-2nd District

"The federal government is tasked with protecting our cherished liberties, not infringing upon them with mandates and intrusions into our lives. Today's ruling affirms another broken promise by President Obama, who misled the American people in selling the law by insisting that the federal mandate was not a tax. ...

"It is bad news for individuals, whose personal health care decisions are threatened by greater government control.

"It is bad news for workers, whose paychecks and jobs are threatened by the hundreds of billions of dollars of new tax hikes and crippling uncertainty from the massive law.

"It is bad news for seniors, whose health security is threatened by the bureaucratic restrictions to access from the law's changes to Medicare.

"It is bad news for future generations, whose prospects for greater opportunity are stifled by the trillions of dollars of new debt that will result from this law. ...

"It is incumbent upon citizens and their elected leaders to clear this partisan roadblock with full repeal and advance common-sense, patient-centered solutions."—Rep. Paul Ryan, R-1st District

"While I still support stronger health care plans, like Medicare for All, President Obama's health care reform was a bold move in the right direction toward providing affordable healthcare for all Americans.

"It is a shame that Paul Ryan did not and continues not to support providing health care for people in his district. From voting against the Affordable Care Act to working to end Medicare as we know it, Paul Ryan would gladly put American families at risk simply to ensure profits for his campaign contributors in the insurance and pharmaceutical industries."—Rob Zerban, a Kenosha Democrat running to unseat Ryan on Nov. 6

"I believe the Supreme Court made the right decision today. There is much more work to be done in controlling health care costs, but the Affordable Care Act brings us closer to providing health care to all Americans at a cost we can afford. ... "As we know, health care costs are a drag on our economy, and the Affordable Care

Act tackles some of the most rapidly growing health care expenses."—Sen. Herb Kohl, D-Wis.

"Today's Obamacare decision establishes that there is no area of Americans' private lives that is off limits to federal intrusion and control. Freedom took a real body blow.

"It is now up to Congress—and hopefully a new president—to repeal this unpopular monstrosity and replace it with free market reforms that will actually

improve the quality and restrain the cost of health care in America."—Sen. Ron Johnson, R-Wis.

Last updated: 8:41 pm Thursday, December 13, 2012

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