Date: 03/26/2013
Final
Health Care Made Easy Presentation
HOUSE COMMITTEE ON PUBLIC HEALTH CARE & HUMAN SERVICES
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01:36 PM -- Health Care Made Easy Presentation
Representative Primavera called the committee to order. Jane Barnes, Director of Consumer and Government Affairs, Centura Health, introduced the presentation.
01:38 PM
Jeff Thompson, Director of Government/Corporate Relations, University Hospital, began by discussing the differences between public and private hospitals. He stated that hospitals are among the most heavily regulated industries in the nation and described the trauma services provided by local hospitals after the Aurora movie theater shootings last summer. Mr. Thompson explained the federal Emergency Medical Treatment and Active Labor Act (EMTALA) law, which requires hospital emergency rooms to treat all patients who arrive at an emergency room. He noted that there are both for- and non-profit hospitals with varying roles and missions and, noted that there are approximately 30 hospitals in Colorado. He stated that Denver Health Medical Center, University Hospital, and Memorial Hospital are considered quasi-governmental hospitals and explained that University Hospital was divested by the University of Colorado in 1991, and so technically, is not a part of state government. Denver Health divested from the City of Denver in the mid-1990's and is now operated by an authority. He described the major Colorado hospital systems, and listed the facilities that are part of the systems. He responded to questions from the committee regarding the Centura Health System and clarified that HCA-Health One is the only for-profit hospital system in the state. He responded to additional questions from the committee regarding EMTALA and hospital readmisssions. Mr. Thompson noted that hospitals are now being penalized under Medicare and Medicaid for avoidable readmissions. He continued to respond to questions from the committee regarding trauma services and religious-based hospital systems. Ms. Barnes responded to questions from the committee regarding the ownership structure of Centura Health.
02:04 PM
Russ Johnson, Chief Executive Officer of San Luis Valley Medical Center, discussed the challenges and strengths of rural health care. He discussed the differences in care due to the demographics of rural areas, and noted that one of the challenges with providing health care in rural areas is attracting and retaining health care providers. He stated that rural areas tend to be lower income, and thus there are more individuals without commercial insurance. He discussed critical access hospitals, and discussed the financial operating margins for rural hospitals. He stated that changes to the Medicaid program greatly affect rural health care centers and responded to questions from the committee regarding the San Luis Valley's participation in the Colorado Regional Health Information Organization (CORHIO). He discussed the incentives that his organization offers to recruit providers and Medicaid coverage expansions. He responded to additional questions about methods to reduce the cost of hospital care and telemedicine.
02:29 PM
Dr. David Watson, Chief Medical Officer, Centura Health Physician Group, discussed physician alignment models. He stated that one model provides full employment of physicians, and described the Centura Health Physician Group, which utilizes a common health medical record. He discussed the data available to providers regarding patient care, which he said allows for improvement in care delivery. He stated his belief that physicians must be accountable for delivering quality care in appropriate settings, and that physicians will embrace payment reform efforts, including bundled payments. He responded to questions from the committee regarding CORHIO and electronic health medical records. He further responded to questions from the committee regarding whether or not physicians practice defensive medicine to avoid lawsuits. A handout regarding Colorado Health Neighborhood Connections was distributed to the committee (Attachment A).
130326 AttachA.pdf
02:47 PM
Renae Pemberton, Centura Health, discussed Accountable Care Organizations and distributed a handout to the committee (Attachment B). She described Centura's Accountable Care Organization (ACO) within the Medicare program, and discussed the goals and challenges of the program. She responded to questions from the committee regarding the differences between managed care and ACOs. She noted that the ACO model is a shared savings model, whereas the managed care system paid a per-member, per-month fee to insurers to manage care.
130326 AttachB.pdf
02:58 PM
Chris Tholen, Colorado Hospital Association, provided an update on the Colorado hospital provider fee and distributed a handout to the committee (Attachment C). He described the Colorado Health Care Affordability Act, which implemented Colorado's hospital provider fee. The purposes of the law were to increase reimbursement to hospitals for Medicaid and the Colorado Indigent Care Program, increase the number of persons covered by Medicaid, and pay the administrative costs of the Department of Health Care Policy and Financing. He described how the Hospital Provider Fee is assessed in Colorado. He described the expansions of Medicaid and the Children's basic health plan that were implemented as a result of the provider fee and how the provider fee has increased provider reimbursements. Specifically, he noted that the Medicaid payment-to-cost ratio has increased from 56 to 80 percent of costs, although Medicare cuts have affected payments to hospitals overall. He discussed the impact of the provider fee on consumers, the state, and hospitals and responded to questions from the committee regarding the impact of the provider fee on Medicaid reimbursements to hospitals.
130326 AttachC.pdf
03:10 PM
Mark Carley, Vice President of Payer Relations, Centura Health, discussed the role of health insurance in the health care system. He responded to questions from the committee regarding the underwriting of individual health insurance policies and his description of insurers as "population health managers." He further responded to questions from the committee regarding coverage for services provided by naturopathic doctors and his testimony regarding the role of insurance in funding new health care technologies.
03:23 PM
Jane Barnes, Director of Consumer and Government Affairs, Centura Health, thanked the committee for their time. Representative Primavera made additional announcements. She noted that the committee had made several recommendations to the Joint Budget Committee during the SMART Government Act hearings and described the Joint Budget Committee's action on those recommendations.
03:27 PM
The committee adjourned.