1 The Unique Role of Physician Owned Medical Facili9es in Texas & The Future of Health Care in Texas Bobby Hillert Congress Avenue Bridge Strategies, LLC Principal Texas Ambulatory Surgery Center Society Executive Director Texas Physician Hospitals Advocacy Center Executive Director
2 Physician Ownership: Important in the Texas Medical Landscape The nation s first hospital was founded in 1751 by a physician (Dr. Thomas Bond) and Benjamin Franklin. Many of the early hospitals were created and managed by physicians. Physician-owned hospitals put patients and physicians in control the patientphysician relationship. Physician-owned hospitals, governed and controlled by the physicians who practice there, are some of the highest quality, most efficient hospitals in the nation (Medicare data, Consumer Reports, etc.). When physicians own and operate hospitals, patients directly benefit because physicians, who are delivering the care, are able to bypass the bureaucracy that typically exists in nonphysician owned hospitals and concentrate directly on what s truly important for a patient s care. Types of Facilities: Hospitals Ambulatory Surgery Centers (ASCs) Clinics Medical Office Buildings Imaging Centers Free-Standing Emergency Departments
3 Physician-Owned Hospitals What Are They? Definition: Any hospital with any amount of physician ownership. Joint-venture with a non-profit hospital (DFW examples: Baylor Health Care System, Texas Health Resources, Methodist, Cook Children s) Children s hospitals Hospitals specializing and excelling in certain specialties Full-service community hospitals Rehab hospitals Psych hospitals
4 Physician-Owned Hospitals Approximately 70 in Texas AMARILLO 2 Hospitals LUBBOCK 2 Hospitals DALLAS FORT WORTH 30 Hospitals EL PASO 2 Hospitals TYLER 1 Hospital AUSTIN 3 Hospitals BRYAN 1 Hospital BEAUMONT 2 Hospitals SAN ANTONIO 3 Hospitals HOUSTON AREA 19 Hospitals CORPUS CHRISTI 1 Hospital Rio Grande Valley 3 Hospitals
6 Texas Physician-Owned Hospitals: Economic Impact Texas Leads in Economic Impact of Doctor Owned Hospitals January 14, 2009 Dallas Morning News By Jason Roberson Texas physician hospitals also will pay close to $86 million in property, payroll and income taxes this year Physician owned hospitals in Texas will infuse $2.3 billion into the state s economy this year
7 Texas Physician-Owned Hospitals CMS Hospital Compare Data Dallas Averages: 12 POHs and 44 hospitals Without Physician Ownership Percent of patents who gave their hospital a ratng of 9 or 10 on a scale from 0 (lowest) to 10 (highest). Physician Owned 82% No Physician Ownership 64% Percent of patents who reported YES, they would definitely recommend the hospital. Physician Owned 83% No Physician Ownership 70% Aus9n Averages: Four POHs and Eight Hospitals Without Physician Ownership Percent of patents who gave their hospital a ratng of 9 or 10 on a scale from 0 (lowest) to 10 (highest). Physician Owned 83% No Physician Ownership 62% Percent of patents who reported YES, they would definitely recommend the hospital. Physician Owned 87% No Physician Ownership 69%
8 Texas Physician-Owned Hospitals Safety & Quality Complication rates at physician hospitals are measurably lower than at general hospitals. Patients are 3 to 5 times more likely to experience complications at general hospitals than at physician hospitals. At physician hospitals, nurse to patient ratios average 1 nurse to 4 patients; However, nurse to patient ratios at hospitals without physician ownership are typically 1 to 8 or higher. Mortality rates are significantly lower in physician hospitals than in other community hospitals for all medical procedures analyzed by the U.S. Department of Health and Human Services (HHS) there was a statistical significance. Source: Study of Physician-Owned Specialty Hospitals Required in 507(c)(2) of the Medicare Prescription Drug, Improvement, and Modernization Act of (HHS Study), 2005, p.53.
9 Texas Physician-Owned Hospitals Medical Industry Support The American Medical Association (AMA) is writing to express support for physician-owned specialty hospitals and opposition to an extension of the 18-month moratorium on physician referrals to specialty hospitals, which was imposed by the MMA Act of AMA Letter to Congress, April 22, 2005 Many large hospital systems joined TMA in the fight restricting physician ownership, noting that partnering with physicians creates new opportunities for both parties to improve patient care and lower costs. TMA s summary of the 2005 TX Legislature
10 Physician-Owned Hospitals: The Outlook
11 Washington, DC Physician Hospital Ownership History MEDICARE PART D 18-month moratorium expires. MEDICARE PART D Senator John Breaux (D-LA) adds harmful POH language to the Medicare Part D bill. SENATE LEGISLATION Senators Chuck Grassley (R-IA) and Max Baucus (D-MT) introduce legislation to stop POHs. BUDGET DEFICIT ACT Senator Grassley adds an9 POH language to the Budget Deficit Act June 2003 December 2003 May 2005 June 2005 October 2005 MEDICARE PART D Signed into law with an 18-month moratorium on new POHs. CMS CMS enacts a moratorium lite on new POHs.
12 Washington, DC Physician Hospital Ownership History SCHIP BILL Harmful POH language removed from House SCHIP bill BUDGET DEFICIT ACT Signed into law and creates a new CMS study on POHs; confirms moratorium-lite. SCHIP BILL Clean SCHIP bill passes without POH language. February 2006 July 2007 September 2007 December 2007 SCHIP BILL General Medicare language (including POH) removed from Senate SCHIP bill. MEDICARE BILL Health bill passes without threatened POH language. SCHIP BILL Harmful POH language added to House SCHIP bill.
13 Washington, DC Physician Hospital Ownership History SCHIP BILL Harmful POH language removed from House SCHIP bill. MEDICARE BILL Clean Medicare bill passes without POH language. SCHIP BILL Clean SCHIP bill passed and signed into law. MENTAL HEALTH PARITY Senator Baucus adds harmful POH language to mental health parity legislation. APPROPRIATIONS BILL Senator Baucus adds harmful POH language to appropria9ons bill (war spending). MENTAL HEALTH PARITY POH language removed as bill passes; threat on AMT tax bill removed. March 2008 April 2008 May 2008 June 2008 July 2008 September 2008 January 2009 APPROPRIATIONS BILL Senate adopts House version (no POH language). FARM BILL Senator Grassley adds harmful POH language to agriculture legislation. RURAL HEALTH BILL Senator Grassley offers standalone bill with harmful POH language.
14 Washington, DC Evolution of Anti-POH Legislation Moratorium on New POHs Medicare Part D law called for a prohibition on new POHs. Expired and resulted in a positive government study of POHs. Moratorium Light CMS added a six-month moratorium and would not end it until CMS reported to Congress. Deficit Reduction Act S (Budget Deficit Act of 2005) required CMS to deliver a report to Congress on charity care by POHs and directed CMS to continue the moratorium. It resulted in requiring all hospitals to notify patients of hospital ownership.
15 Washington, DC Evolution of Anti-POH Legislation July 2007 March 2008 April 2008 First House SCHIP Bill Requirements: Medicare provider agreement as of July 24, No increase in ORs or beds. Limit amount of physician ownership to no more than 40 percent. Limit each individual physician s interest to no more than 2 percent. H.R eventually failed. Farm Bill H.R made changes to please Nebraska and Wisconsin senators. Eligible hospitals could expand by 100 percent. No ownership caps for individual and aggregate physician ownership. POH provisions eventually stripped. Mental Health Parity The POH provisions in H.R were nearly the same as the House s July 2007 SCHIP bill. Introduction of expansion provision for POHs. Bill eventually failed.
16 Washington, DC Evolution of Anti-POH Legislation May 2008 June/July 2008 January 2009 War Bill War appropriations bill witnessed the expansion clause for a handful of hospitals. The bill changed by starting with no more than 40 percent aggregate physician ownership to the greater of 40 percent or the percentage of ownership as of date of enactment. POH language was stripped. Medicare SGR Bill POH provisions were similar to the appropriations bills. Eventually removed from the bill. Second House SCHIP Bill Requirements: Medicare provider agreement as of January 1, No increase in ORs or beds. Limits ownership to the aggregate as of date of enactment. No limit on individual ownership. Limited expansion. POH provision removed before bill signed into law.
17 Washington, DC Federal Health Bills Oct 2009 Nov 2009 March 2010 House Bill H.R would have ended the whole hospital exemption on January 1, Senate Bill H.R would have extended the date for under development hospitals to February 1, New Health Care Law Whole hospital exemption ends on date of enactment ( ). Under development POHs will have until December 31, 2010 to acquire Medicare number.
18 Washington, DC Physician Hospital Ownership History Federal Health Care Bill No new physician ownership allowed after March 23, All existing hospitals grandfathered in. No expansion of physician ownership, operating rooms, beds or procedure rooms allowed. Hospitals currently under development (several in Texas) have until December 31, 2010 to get their Medicare provider number. Many new projects across the country have been killed.
19 The State of Texas Ambulatory Surgery Center Environment
20 Overview: A Sample of ASCs in Each State VT 21 - NH 56 - MA 44 - CT 7 - RI 25 - DE NJ 4 - DC MD
21 Overview: A Sample of the 400 Texas ASCs Employ 7,300 Texans. $1.7 billion economic impact. $424 million in taxes. El Paso 9 ASCs West Texas Over 40 ASCs Dallas/Fort Worth Over 100 ASCs AusTn Area Over 18 ASCs East Texas Over30 ASCs San Antonio Over 30 ASCs Houston Area Over 80 ASCs South Texas Over 20 ASCs
22 Breakdown: A Sample of the Nearly 400 Texas ASCs Specialty ASCs with this specialty Percentage with this specialty Ophthalmology % 42 Gastro 93 24% 63 Plas9cs % 15 Pain Mgmt 66 17% 13 Foot % 0 Oral 59 15% 0 OB GYN % 2 Urological 24 6% 1 Otolaryngology 82 21% 1 Orthopaedic 72 19% 1 Thoracic 11 3% 0 Neurological 26 7% 0 Sole Specialty
23 A Snapshot: The Texas ASC Industry Over a quarter of arthroscopic shoulder surgeries for Texas residents were performed in ASCs (Medicare). 41 percent of colonoscopies for Texans were performed in ASCs (Medicare). 65 percent of cataract removal/lens insertion surgeries in Texas occurred in ASCs (Medicare). 48 percent of arthroscopic surgeries of the knee for DFW residents were performed in ASCs (Medicare). 45 percent of carpal tunnel surgeries for residents of Houston were performed by ASCs. 67 percent of complex cataract surgeries for rural residents were performed in ASCs.
24 Texas ASC Industry: State Public Policy Issues Physician Ownership Workers Comp Managed Care ASC ReporTng
25 The Short-Term Future: What the Texas Health Care Landscape Could Look Like
26 Washington: Austin: The recently passed health care bill will result in our health care system remaining pretty much the same over the next few years. However, the 2011 Texas Legislature could usher in these changes much sooner.
27 Key Public Policy Trends Washington, DC & Austin Washington, DC Austin Progressive Payment Models Large Medicare pilot projects; several years away State employees possible; 2011 Insurance Coverage Insurance Exchanges could complete change individual, small group, and employer insurance States could play the biggest role in determining this future Physicians employees of health system Declining Medicare Rates leading to physician realignment Corporate Practice of Medicine in TX: coming soon Commercial Insurance Reimbursement Commercial plans following Medicare s lead State Government playing larger role in PPOs; network adequacy
28 Key Public Policy Trends Washington, DC & Austin Washington, DC Austin Health Care IT Medicare incentive payments for hospitals/ physicians Medicaid program starting an incentive payment plan Imaging Medicare cuts began in 2007; continuing with the new health care bill Legislature will examine in-office imaging. Retail/Emergency Clinics Little action at the federal level. State regulates freestanding ERs.
29 Public Policy and Industry Trends: Progressive Payment Models (ACOs) BACKGROUND A number of progressive payment models accountable care organizations (ACOs), bundled payments, gainsharing, medical homes, etc. exist at the federal and state levels. TAKEAWAY ITEM Federal lawmakers wanted to switch health care to a system that utilized the bundled payment model. However, they believed that providers were not ready for that yet. OUTLOOK There will be a strong push in the 2011 Texas Legislature to ACO pilot projects for the state employee health plans in select cities (Dallas, Houston and Lubbock).
30 Public Policy and Industry Trends: What an ACO Looks Like Manage Continuum of Care 3 Days Before Surgery Surgery/ Hospitaliza tion 30 Days After Hospital
31 Public Policy and Industry Trends: What Are These Models? Progressive payment models come in a variety of forms and are hard to define. Accountable care organizations (ACOs), bundled payment plans, gain-sharing, physician-hospital organizations (PHO), integrated health organizations (IHOs) and medical homes are some examples. Examples: Austin Pediatric Surgeons This has been completed (Medicaid project). It saved nearly $80,000 (with the surgeons receiving half of the savings). Austin Regional Clinic This should begin in September 2010 and involve the patient-centered medical home (Medicaid project). Medicare Physician Group Practice Demonstration Project This includes 10 physician groups, averaging 500 physicians and 22,000 beneficiaries (National Medicare project). MedPAC has found increased quality; however, no savings yet. Baptist Health System (San Antonio) The acute care episode (ACE) demonstration project is one of five national pilot projects (Medicare) to examine a shared savings surgery initiative. The system found $2 million in savings.
32 Public Policy and Industry Trends: Insurance Coverage BACKGROUND The new health care law requires states to develop health insurance exchanges. Many of the new insureds will be Medicaid. TAKEAWAY ITEM This will likely wipe out the individual and small group markets. In addition, large employers exploring this option. Insurance might not be more affordable due to the fact that states will still be in control of mandates. OUTLOOK It is too early to tell if this will have an impact on decreasing the cost of insurance. It could have a positive impact if: the pools are increased (place all state employees, Medicaid and SCHIP into the exchanges), have community rating like FEHBP and pre-empt mandates.
33 Public Policy and Industry Trends: Commercial Insurance Reimbursement BACKGROUND Commercial insurance plans are making major changes regarding in-network reimbursement. Out-of-network providers are facing major changes as well. TAKEAWAY ITEM Health care providers are witnessing lower reimbursement rates from commercial plans. OUTLOOK This could lead to a greater consolidation of physician practices. In particular, one and two person provider groups could try to consolidate with other groups.
34 Public Policy and Industry Trends: Physician Employment BACKGROUND Texas is one of the few states that does not allow corporate entities (with a few exceptions) to employ physicians. Due to increased financial pressures on practices, a growing number of physicians are expressing an interest in being employed by health care systems. In addition, health care systems are growing more interested in this model as well. TAKEAWAY ITEM This is a state issue that will come up in the 2011 TX Legislature. Last year s legislature witnessed an attempt to allow hospitals to employee physicians in counties a population of 50,000 or less. OUTLOOK Health and hospital systems will continue utilizing the 501a model that is popular in Texas. In particular, a management services organization (MSO) model that is physician-owned could be attractive.
35 Industry Integration Industry Developments in Texas Note: I am not suggesting that this potential acquisition occurred as a result of accountable care models. However, it does represent an industry trend of large health systems to acquire smaller, independent facilities. Two Steps: St. David's to manage Austin Heart practice Doctor/hospital affiliations new trend in health care Austin American-Statesman, Dec 2, 2009 St. David's HealthCare to buy Heart Hospital of Austin Austin American-Statesman, February 16, 2010
36 Public Policy and Industry Trends: Primary/Emergency Care Clinics BACKGROUND Seeking a new avenue for adding a new patient stream, both physicians and hospital systems have added primary and emergency care clinics and free-standing emergency departments. TAKEAWAY ITEM The state of Texas made its first attempt at regulating the industry in 2009 with the licensing of free-standing emergency departments (HB 1357). There has not been any action at the federal level. OUTLOOK Free-standing emergency departments will attempt to amend the law by allowing more primary care services in this setting. Health and hospital systems will continue developing these facilities as a way to draw patients.
37 Public Policy and Industry Trends: Imaging BACKGROUND The latest Medicare rule concerning physician payment made a very negative impact on imaging in the ancillary setting. In particular, cardiology took a major hit while oncology avoided large cuts. TAKEAWAY ITEM There will be continued pressure on imaging in the in-office setting. As a result, more imaging will be driven back to the hospital setting (which can pay four times as much). OUTLOOK Health and hospital systems will continue partnering with physicians (in particular, cardiologists) in 501a partnerships s Budget Deficit Act First large cuts to in office imaging 2009 s Medicare Bill AddiTonal cuts to in office In office credentaling (2012) 2010 s Reform Law Cuts to in office MRI, PET, CT
38 To subscribe to the State of Texas Health Policy analysis newsletter, please your contact information to: Bobby Hillert Congress Avenue Bridge Strategies, LLC
DSHS expects commercial product Basic Service HMOs to report Texas subset of HEDIS 2015 (2014 data) for the following service areas based on enrollment numbers as of December 31, 2013. BASIC SERVICE HMO's
Accountable Care Organizations: An old idea with new potential Stephen E. Whitney, MD, MBA Testimony to Senate State Affairs September 22, 2010 Impetus for ACO Formation Increased health care cost From
SPECIAL BULLETIN Monday, March 22, 2010 This summary is five pages. Summary of Major Provisions in Final House Reform Package The U.S. House of Representatives late yesterday voted to pass landmark health
Patient Protection and Affordable Care Act (H.R. 3590) and the Reconciliation Bill (H.R. 4872) March 24, 2010 Color Code: Hospitals Insurance Coverage Other/Workforce Delivery System 2010 Expands the RAC
Post-care Networks and LTACs: Finding Your Place in an ACO Model Accountable Care Organizations (ACOs) are more than just a fad. Post-care providers and LTACS in particular, will need to give careful thought
Acute Care Episode (ACE) Demonstration Gary L. Whittington CFO, Region Services Baptist Health System San Antonio, Texas Daniel Hurry VP, Supply Chain & Purchased Services Baptist Health System San Antonio,
Outlet: Austin Business Journal (online) Unique Visitors Per Month: 151,284 Link: http://www.bizjournals.com/austin/prnewswire/press_releases/georgia/2014/12/17/la92883?ana=prnews Outlet: Dallas Business
The Patient Protection & Affordable Care Act: Next Steps in Maine February 8, 2013 1 Maine Medical Association Voluntary membership association of over 3,600 Maine physicians, residents, and medical students
Fact Sheet AARP Public Policy Institute How Health Reform Will Affect Health Care Quality and the Delivery of Services The recently enacted Affordable Care Act contains provisions to improve health care
Children s Hospital Association of Texas An Association for the Advancement of Children s Healthcare in Texas CHAT Nursing Conference, November 6, 2010, Austin, Texas Ed Berger, VP, Advocacy & Government
What Are Ambulatory Surgery Centers? Ambulatory surgery centers, or ASCs, are facilities where surgeries that do not require hospital admission are performed. ASCs provide cost-effective services and a
This Week in Washington D.C.: 1. CMS releases final regulations on 2011 Medicare physician reimbursement and ASC payments 2. Republicans take over House in the mid-term elections Medicare Physician and
Implementation Timeline Reflecting the Affordable Care Act 2010 Access to Insurance for Uninsured Americans with a Pre-Existing Condition. Provides uninsured Americans with pre-existing conditions access
Prevention and Screening Services Cost-sharing Eliminates cost sharing requirements for requirements for all preventive services (including prevention and colorectal cancer screening) that have a screening
Ambulatory Surgery Centers: Valuation Process & Key Benchmarks Chance Sherer, CVA Director 1 PRESENTATION OVERVIEW I. Industry Background II. III. Valuations: When and Why Types of Transactions IV. Overview
Valuations and M&A Activity Todd J. Mello, ASA, CVA, MBA Co-Founder and Partner Disclosures Co-founder and owner in HealthCare Appraisers, Inc. No ownership in private or publicly-traded hospital chains,
Physician Inpatient/ Outpatient Revenue Survey A survey showing net annual inpatient and outpatient revenue generated by physicians in various specialties on behalf of their affiliated hospitals Merritt
PAs and Provisions of Health Reform What does it Mean to You? Presentation to the South Dakota Academy of Physician Assistants March 7, 2013 Liz Roe, Director, Constituent t Organization Outreach and Advocacy
President Obama Signs the Temporary Payroll Tax Cut Continuation Act of 2011 --New Law Includes Physician Update Fix through February 2012-- On Friday, December 23, 2011, President Obama signed into law
Getting Ready for 2014: The Big Year for Healthcare Reform Anne Arundel County SHRM David Johnson email@example.com November 15, 2012 0 Topics for Discussion 1. Recap of Supreme Court Decision on Affordable
Larry R. Kaiser, MD President The University of Texas Health Science Center at Houston HealthCare Workforce: UTHealth Experience CHALLENGE To train the Healthcare Workforce of the 21 st Century SOLUTIONS:
Summary of Federal SCHIP Reauthorization, Economic Stimulus, and Health Care Reform Bills and Proposals I. Children s Health Insurance Program (CHIP) Reauthorization Act of 2009 A. Funding for CHIP. The
INTEGRATION STRATEGIES FOR A NEW HEALTH CARE ECONOMY Thomas William Baker Baker Donelson Bearman Caldwell & Berkowitz, P.C. Atlanta, Georgia (404) 221-6510 firstname.lastname@example.org Prepared for East Georgia
Texas Turnaround The Impact of Lawsuit Reform on economic Activity in the Lone Star State April 2008 A recently completed study by The Perryman Group found that the enactment of a series of lawsuit reforms,
October 18, 2013 Articulating the Value Proposition of Innovative Medical Technologies in the Healthcare Reform Landscape Outline The Changing Landscape Evolving Care Delivery and Incentive Models Provider
Federal Health Care Reform: Implications for Hospital and Physician partnerships Walter Kopp Medical Management Services Outline Overview of federal health reform legislation Implications for Care delivery
PL 111-148 and Amendments: Impact on Post-Acute Care for Health Care Systems By Kathleen M. Griffin, PhD. There are three key provisions of the law that will have direct impact on post-acute care needs
CENTER FOR HEALTHCARE RESEARCH & TRANSFORMATION Policy Brief June 2010 The Patient Protection and Affordable Care Act at the State and Local Level While health care reform has its foundation and framework
Comparing Texas HMOs 2014 Health Plan Quality From the Consumer s Point of View All Regions Included: Central Texas East Texas Gulf Coast Texas North Texas Panhandle/Plains Texas South Texas West Texas
Affordable Care Act at 3: Strengthening Medicare ISSUE BRIEF Fifth in a series May 22, 2013 Kyle Brown Senior Health Policy Analyst 789 Sherman St. Suite 300 Denver, CO 80203 www.cclponline.org 303-573-5669
MGMA ACA Exchange Implementation Survey Report May 2014 Overview Medical Group Management Association (MGMA) conducted member research in April 2014 to better understand the impact of the Affordable Care
IMPLEMENTATION OF THE AFFORDABLE CARE ACT IN TEXAS Kathy Eckstein Director of Public Policy Children s Hospital Association of Texas February 2014 CHAT Mission and Members The mission of CHAT is to support
Accountability and Innovation in Care Delivery Models Lisa McDonnel Senior Vice President, Network Strategy & Innovation, United Healthcare November 6, 2015 Today s discussion topics Vision Our strategic
ALBANY AMSTERDAM ATLANTA AUSTIN BOSTON CHICAGO DALLAS DELAWARE DENVER FORT LAUDERDALE HOUSTON LAS VEGAS LONDON* LOS ANGELES MIAMI NEW JERSEY NEW YORK ORANGE COUNTY ORLANDO PALM BEACH COUNTY PHILADELPHIA
The Affordable Care Act What does it mean for internists? Joshua Becker MD 10/14/2015 VII. 2015 Reforms and Beyond Payment Penalties under Medicare s Pay-for-Reporting Program Value-Based Payment Modifier
Washington State Health Care Authority Comments: Department of Health and Human Services Essential Health Benefit Bulletin The Washington State Health Care Authority (HCA) is pleased to submit comments
Health Insurance Reform at a Glance Implementation Timeline 2010 Access to Insurance for Uninsured Americans with a Pre-Existing Condition. Provides uninsured Americans with pre-existing conditions access
Accountable Care Organizations Rick Shinto, MD Aveta Health Inc. July 20, 2010 1 Health Care Reform- New Models of Care Patient Protection and Affordable care Act (PPACA 2010) controlling costs and improving
The Affordable Care Act: Is Healthcare Becoming More Affordable? Houston Economics Club Federal Reserve Bank of Dallas, Houston Branch November 17, 2014 Vivian Ho, PhD James A. Baker III Institute Chair
Social Security, SSI, and Medicaid Basics T.J. Sutcliffe, The Arc Julie Ward, The Arc Basics Basics Income Maintenance Health Insurance Means Tested Supplemental Security Income (SSI) Title XVI Medicaid
Health Reform and the AAP: What the New Law Means for Children and Pediatricians Throughout the health reform process, the American Academy of Pediatrics has focused on three fundamental priorities for
Summary of the Major Provisions in the Patient Protection and Affordable Care Act Updated 10/22/10 On March 23, 2010, President Barack Obama signed into law comprehensive health care reform legislation,
Hot Topics in Practice of Medicine and Dentistry Dallas Bar Association-Health Law Section, September 16, 2015 Michael S. Byrd and Bradford E. Adatto 8150 N. Central Expressway, Suite 930 Dallas, Texas
United States Government Accountability Office Report to Congressional Requesters June 2015 MEDICARE PART B DRUGS Action Needed to Reduce Financial Incentives to Prescribe 340B Drugs at Participating Hospitals
The Texas Legislature Leads the Way: Empowering Agency Response - Beating Backlogs and Helping Healthcare Kyle Mitchell, Deputy Executive Director Presentation to National Conference of State Legislators
May 2009 Winstead PC POTENTIAL OPPORTUNITIES FOR HEALTHCARE INDUSTRY UNDER THE AMERICAN RECOVERY AND REINVESTMENT ACT OF 2009 Contact: The American Recovery and Reinvestment Act of 2009 (the "Act") was
Reforming and restructuring the health care delivery system Are Accountable Care Organizations and bundling the solution? Prepared by: Dan Head, Principal, RSM US LLP email@example.com, +1 703 336 6536
LWVSD UNIT PRESENTATION, SEPTEMBER, 2009 "HEALTHCARE: HELPING YOU FOLLOW THE DEBATE" Luncheons a) Tuesday, September 22nd - Retired State Senator Sheila Kuehl, "What's So Great About Single Payer Healthcare".
Health Care in Rural America Health care in rural communities has many aspects access to physicians, dentists, nurses, and mental health services; the financial circumstances of rural hospitals; federal
California Association of Public Hospitals and Health Systems April 2009 POLICY BRIEF 70 WASHINGTON STREET, SUITE 215 OAKLAND, CALIFORNIA 94607 510.874.7100 WWW.CAPH.ORG California Public Hospitals and
PREVENTION COLLABORATION IN ACTION Engaging the Right Partners Primary Care 101: A Glossary for Prevention Practitioners As the U.S. healthcare landscape continues to change under the Affordable Care Act
SURVEY Physician Appointment Wait Times and Medicaid and Medicare Acceptance Rates A survey examining the time needed to schedule a new patient appointment with a physician in major metropolitan markets
A NATIONWIDE PUBLIC INTEREST RELIGIOUS CIVIL LIBERTIES LAW FIRM 1055 Maitland Center Cmns. Second Floor Maitland, Florida 32751 Tel: 800 671 1776 Fax: 407 875 0770 www.lc.org 1015 Fifteenth St. N.W. Suite
BILL: SB 516 The Florida Senate BILL ANALYSIS AND FISCAL IMPACT STATEMENT (This document is based on the provisions contained in the legislation as of the latest date listed below.) Prepared By: The Professional
Liability Limits in Texas Fail to Curb Medical Costs December 2009 Acknowledgments This report was authored by David Arkush, Peter Gosselar, Christine Hines and Taylor Lincoln. About Public Citizen Public
Report on Emergency Medical Services As Required By Health and Safety Code, Sec. 773.05713 Department of State Health Services December 2014 Table of Contents Executive Summary..2 Background.. 2 Legislative
PHYSICIANS / SURGEONS American Academy of Audiology American Academy of Neurology American Academy of Physical Medicine & Rehabilitation American Academy of Ophthalmology Academy of Correctional Health
Evolving UM SOM Clinical Practice as the Healthcare Environment Changes Introduction to the UM SOM Medical Service Plan This section will cover the following elements: 1. FPI creation, organization, and
ECONOMIC OUTLOOK: TEXAS AND THE AUSTIN REGION Texas Office of the Governor Economic Development and Tourism Division Market Texas as a leading business location Advertising and business recruitment trips
Revenue Cycle Management + Value-Based Medicine Presented by: Justin T. Barnes, VP of Industry & Government Affairs Bryan Koch, VP of Revenue Cycle Solutions Safe harbor Safe harbor statement under the
The American Society for Clinical Pathology Policy Statement Self-Referral, Markups, Fee Splitting, and Related Practices (Policy Number 04-03) Policy Statement: ASCP strongly supports federal and state
WORKING PAPER SERIES UNPRECEDENTED GROWTH, QUESTIONABLE POLICY: THE 340B DRUG PROGRAM BY STEPHEN T. PARENTE, PHD, MINNESOTA INSURANCE INDUSTRY CHAIR OF HEALTH FINANCE, DEPARTMENT OF FINANCE & MICHAEL RAMLET,
Healthcare Reform (ACA) Update Greater Magnolia Chamber of Commerce FREDDY WARNER System Executive, Public Policy & Government Relations Memorial Hermann Health System March 27, 2014 PRESENTATION OUTLINE
Candidate Position on the Private Healthcare System (as of November 2015) Clinton Defends the ACA Sept. 23, 2015 Plan outlines Clinton s proposals: Lower Deductibles, Coinsurance, and Co Pays Up to three
Affordable Care Act: Smooth or White Waters Ahead? Kathleen Bradbury-Golas, DNP, RN, NP-C, ACNS-BC Assistant Professor, Felician College Family Nurse Practitioner, Virtua Atlantic Shore Family Practice
Outdated coverage policies in Florida USED TO limit cancer patients access to lifesaving drugs! Traditionally, IV chemotherapy treatments are covered under a health plan s medical benefit where the patient
Healthcare Reform Update Conference Call VI Sponsored by the Healthcare Reform Educational Task Force October 9, 2009 2:00-2:45 2:45 pm Eastern Healthcare Delivery System Reform Provisions in America s
Accountable Care Organizations Understanding What They Are and How to Structure Them Maria T. Currier HOLLAND & KNIGHT LLP Miami Chamber of Commerce Healthcare Subcommittee December 7, 2010 Copyright 2010
Spencer Berthelsen, M.D. Texas Club of Internists April 4, 2014 Cost The US spends twice as much per capita as the average of other industrialized nations Institute of Medicine 30% of healthcare dollars
What s in the Healthcare Law for you and your Business How the new law impacts your bottom line Marcia Dávalos Disneyland Hotel - Anaheim, CA October 17, 2013 About Small Business Majority Small business
submitted anytime during the year to your institution HR/Benefits Office, and the tobacco premium will be waived beginning the first of the month following submission of the form. Important: A member is
ICCMHC Winter Conference February 17, 2011 Managing Health Care Reform Benefit Changes within your Own Organization John F. Gause, President firstname.lastname@example.org Overview Health Care Reform - Short Term Impact
December 21, 2012 The Honorable Harry Reid Majority Leader U.S. Senate S-221 U.S. Capitol Washington, DC 20510 The Honorable Mitch McConnell Republican Leader U.S. Senate S-230 U.S. Capitol Washington,
Figure 1. The challenge confronting U.S. Health Care Spending, Quality -- and the Health of the Public Medicare spending per enrollee (2003) Red dots indicate Wisconsin and Minnesota HRRs 12,000 Medicare
Cornerstone Health Care s ACO Playbook Grace E. Terrell, MD January 17, 2012 Mission: To be your medical home Vision: To be the model for physician-led health care in America Values: As a physician owned
What do ACO s and Hospitals want from SNF s and CCRC s Presented to the Institute of Senior Living, April 11, 2013 A Division of Kindred Healthcare 1 Assessing the match: What hospitals and ACO s currently
Note: This material is not intended to serve as legal advice and only constitutes Delta Dental s opinion on the subject matter contained herein based on its own review of available guidance. Delta Dental
Timeline: Key Feature Implementations of the Affordable Care Act The Affordable Care Act, signed on March 23, 2010, puts in place health insurance reforms that will roll out incrementally over the next
N A T I O N A L PHYSICIANS A L L I A N C E My name is Dr. Valerie Arkoosh. I am an Anesthesiologist at the University of Pennsylvania School of Medicine and the President of the National Physicians Alliance.