For hospitals, Supreme Court reform ruling isn't all upside

Although hospitals and healthcare groups have praised parts of last week's Supreme Court's ruling on the Patient Protection and Affordable Care Act, hospitals still face tough challenges when 2014 regulations kick in, The Washington Post reported

Although hospitals won't have to bear as much of the the cost of treating the uninsured, according to the Post, they'll still be responsible for achieving quality-care regulations to qualify for reimbursement and with payment based on readmission rates and patient satisfaction scores.  

In addition to quality pressures, providers have voiced concerns about Medicare and Medicaid. Although generally supporting the high-court ruling to uphold reform, providers softened their applause because of "flaws" in the health law that ignore the underlying problem of patient access to physicians, the California Medical Association said in a statement Thursday.

In California, a state with the nation's largest uninsured population of 7 million, the state medical association said Medicare and Medicaid programs are "grossly underfunded," according to the California HealthCare Foundation's Center for Health Reporting.  

Don Sheldon, president and CEO of EMH Healthcare in Ohio said in The Chronicle-Telegram, "I don't think the healthcare law as passed is a perfect piece of legislation, but it was very important for the country to begin to act on the challenge of providing health care coverage for everyone and controlling the cost." EMH's uncompensated care totaled nearly $46 million in 2011.  

Although more people will be covered, hospitals will see less money, according to Ed Oley, president and CEO of Mercy Regional Medical Center in Ohio.

"[T]he mandate now has to be paid for, and to be able to fund it, we expect over time fairly substantial reductions in the reimbursements of the services we provide today," Oley said in the article.

Still, other hospitals worry that even with the health law, states will face the ever-growing problem of uncompensated care.

"If we opt out [of Medicaid expansion], we're still going to have this issue of people going to hospitals without coverage and continuing to add to the uncompensated care," Peter Wertheim, the vice president for strategic communications at the Arizona Hospital and Healthcare Association, said in a Huffington Post article.

Sheryl Skolnick, an equities analyst at CRT Capital Group in Stamford, Conn., summed it up: "That risk is real and meaningful: the hospitals may end up paying for the poorest and sickest of today's uninsured anyway and see cuts in Medicare and Medicaid on top of that," she told clients Friday, the Huffington Post reported.

For more information:
- read the Washington Post article
- see the CMA statement
- here's the Chronicle-Telegram article
- see the Center for Health Reporting article
- see the Huffington Post article

Related Articles:
Healthcare leaders give reform ruling mixed reviews
Supreme Court upholds healthcare reform
Nonprofit hospitals hurt by any Supreme Court ruling
Hospitals to see more bad debt without health reform
Hospitals, docs unsatisfied with Affordable Care Act

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