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Lincoln Association of Health - PowerPoint Presentation

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Lincoln Association of Health - PPT Presentation

Underwriters February 18 2014 Healthcare Reform Impact on Providers 5 Mission and Vision Mission Bryan Healths mission is to advance the health of individuals in our region through collaboration with physicians and communities ID: 555312

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Slide1

Lincoln Association of Health UnderwritersFebruary 18, 2014

Healthcare Reform Impact on ProvidersSlide2

5Slide3

Mission and VisionMission Bryan Health’s mission is to advance the health of individuals in our region through collaboration with physicians and communities.

Vision 2015

To be the partner of choice as the leading regional health system, through integration, collaboration and the relentless pursuit of excellence.  

4Slide4

Medical Center FactsLargest hospital in Lincoln with approximately 534 physicians

,

3,250

employees and

600 volunteers and 56% inpatient market share.

Serves the

Lincoln market and over 50 cities and towns in Nebraska, Kansas, Missouri and Iowa.

Largest private employer in the capital city of Lincoln.

Nationally recognized for services and outcomes in many specialties including orthopedic, cardiac and neurosurgical services.

8Slide5

$506 million revenues and 3,700 employees$40+ million in charity care (cost = $14 million)$56 million unreimbursed costs from government programs71,000 emergency room visits

47% of inpatient revenue comes from outside Lancaster county

Sponsor of 39-hospital Heartland Health Alliance

Bryan Health: Did you know?Slide6

“Not-for-Profit hospitals saw declines in volumes, revenue growth” – Moody’s Investor Service“2012 May have been the ‘high water mark’ year for hospitals” – Fitch

“Moody’s predicts slow revenue growth, confirms negative outlook” –

Advisory Board Daily Briefing

“In states that say not to Medicaid, hospitals worry of “death by 1,000 cuts” –

Advisory Board

What’s the State of Healthcare Providers?Slide7

ACA Gives 32 Million Coverage

Source: SSB SolutionsSlide8

The Changing Business modelSlide9

U.S. Lives Buying Value by Funding Source

Source: Oliver WymanSlide10

“In the exchanges, many plans will limit hospital choices.”“Houston, we have a problem: Most young Americans haven’t heard of the exchanges.”“Hospitals: We want an ACA delay too.”“Doctors may see pay delay in ACA exchanges.”

Source: Advisory Board Daily Briefing

What’s the State of Healthcare Providers?Slide11

Declining volumes and declining reimbursementNo clear business modelInconsistent quality results being publishedRun to safety through mergers and alliances

What’s the State of Healthcare Providers?

Strong, vulnerable, fragile, scaredSlide12

Living it for three yearsReimbursement cutsValue-based reimbursementReimbursement penaltiesTransparencyNew IT requirementsProfits at highest levels

FTE cuts

Supply negotiations

Benefit plan changes

Lean processes

Are We Ready for Health Care Reform?Slide13

“I can’t wait for the Exchanges – I’ll finally be able to get insurance!”“This Obamacare is really causing me to make lifestyle changes!”

“Looks like my premiums will really be going down!”

“I’m confident the government won’t increase my penalty.”

1. “It all seems so simple!”

What About Exchanges?

5 Things You Haven’t HeardSlide14
Slide15

Exchanges bring consumerismChallenge for consumer: Poor dataChallenge for providers: High deductibles = charity and bad debtMedical Homes workPopulation health management IT systems are almost ready for prime time

Providers working together with similar incentives

OptimistSlide16
Slide17

Participant StructureSlide18

Regional Provider NetworkBryan Health

Columbus Community

Hospital

Faith

Regional Health Services

Fremont Area Medical

Center

Great Plains Regional Medical Center

Mary Lanning HealthcareThe Nebraska Medical Center

Nebraska Methodist Health System

Regional West Health ServicesSlide19

Regional Provider Network

Founding Health

Systems

Critical Access HospitalsSlide20

Networks are already formingEmployers seem committedExchange products are in placeMoney-making volumes continue to declineRates continue to decline

Why Things Will ChangeSlide21

Won’t necessarily result in more careWon’t necessarily result in better careCan we get medical homes to workSome payment is better than none

What About Medicaid ExpansionSlide22

Access Physicians limiting government business; new entrants to fill gap?Narrow networksCritical but unprofitable servicesContinuing High QualityAttracting the best physicians and nurses

Capital for replacement and new technology

Implication: Philanthropy

Workforce Health and Recruiting

Community Resources Will Be Crucial

What’s the Value of Non-Profit, Tax Exempt Providers?

Issues For Lincoln and Nebraska