As Republicans continue to hammer out what an Affordable Care Act repeal and replacement plan will look like, hospitals must brace for uncertainties and potential opportunities that may arise as part of the transition.
One study has found that many hospitals could close if they lose government funds and have to care for more uninsured Americans. Another estimates that the impact on hospitals over the next decade could be $165 billion.
Steven Corwin, M.D., president and chief executive of NewYork-Presbyterian, an integrated academic healthcare delivery system that includes 10 hospitals, told The Wall Street Journal that he is most worried that patients who lose coverage under a repeal won’t have an option of a comparable plan that is affordable and provides access to coverage,
If millions of previously insured patients lose coverage as a result of the repeal, hospitals will once again bear the brunt of the cost of caring for the uninsured.
“If the Medicaid dollar or the Medicare dollar diminishes, then our issue will be, how do we compensate for that,” Corwin told the newspaper. “We’re not going to be able to cost shift. I think that then it will be, how do we keep Medicare and Medicaid beneficiaries out of the hospital? We may have to have a bigger ambulatory footprint to enable us to achieve that.”
Corwin says he hopes that Congress will support a plan that maintains Medicaid expansion, invests in new technologies, such as digital health, and provides access to preventive healthcare and behavioral health services.
But the worst thing hospitals can do while waiting for official word from the government is nothing, said one healthcare policy expert. Paul Keckley, Ph.D, suggested hospitals continue with plans for shared risk arrangements, take steps to reduce costs now, and work with national and regional advocacy groups to make sure lawmakers understand the impact of repeal and replace to healthcare organizations.