Panel hashes out challenges, expectations for Medicaid expansion

Pictured from left to right: Bruce Siegel, Matt Salo, Charles N. Kahn III, Walter Ettinger, Stan Dorn and moderator Joanne Kenen.

A panel of healthcare experts weighed in on the upcoming expectations and challenges of Medicaid expansion and what it will mean for states across the country at the Politico Pro Healthcare Breakfast Briefing Thursday morning in Washington, D.C.

Five panelists fielded questions and fostered discussion on topics such as realistic Medicaid enrollment goals and the nationwide shortage of physicians.

Stan Dorn (pictured second from right), a senior fellow at the Urban Institute Health Policy Center, doesn't think Medicaid enrollment would reach its 7 million enrollment goal. However, he said there would be a large number of enrollees in states that run their own programs, averaging seven times more money for expansion as compared to federally-operated state programs. 

Matt Salo (pictured second from left), executive director of the National Association of Medicaid Directors, said the enrollment goal is realistic, but the demographics of the enrollees--such as their age and overall health--are more important than the numbers. Are the people enrolling young and healthy, he wondered, or old and ill?

Even if the government doesn't meet the enrollment goal, hospitals will see a jump in patronage, according to Charles N. Kahn III (pictured left middle), president and chief executive officer of the Federation of American Hospitals. People with insurance behave differently than people without coverage, so hospitals can expect to experience some surges, he said, but it will vary by state and regional location.

"I don't think the whole world changes Jan.1. I think it changes gradually," Kahn said, echoing other panelists' comments that many hospitals aren't prepared for the possible influx. "At the end of the day, we're not going to have enough physicians."

To deal with the the physician shortage, Walter Ettinger, M.D., (pictured right middle), chief medical officer for the University of Maryland Medical System, said the healthcare system will have to evolve and change, both in model and practice, He said the shift means distributing responsibilities and tasks to a team of healthcare professionals and offering care outside the walls of a hospital in places such as retail clinics.

"We need to change the way we're delivering care," Ettinger said. "It comes back to the idea of giving care in a way we never have before."

Bruce Siegel, M.D. (pictured far left), president and chief executive officer of America's Essential Hospitals, said it is up to business communities to push politicians toward embracing expansion. He also predicted a larger-than-anticipated amount of mergers and consolidations in the hospital realm. "The number of upcoming consolidations will be breathtaking," he said.

To learn more:
- here's Politico's coverage

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