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Panelists plan to seek reimbursement fixes


By Shawn Rhea
Posted: April 20, 2010 - 5:15 pm ET
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Hospital lobbyists speaking at the Greater New York Hospital Association annual meeting said they will use healthcare reform's three-year implementation period to push for fixes to what they believe will be problems in the reimbursement system under reform.

Disproportionate-share hospital reimbursement and Medicare physician payment are “areas that will need tweaking as we move along toward implementation,” said Blair Childs, senior vice president of public affairs for Premier, a healthcare group-purchasing and quality-improvement organization.

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Childs and others who spoke during a panel on reform implementation said that the new law will make some significant improvements to provider reimbursement through insurance-coverage expansion and mandates. But they also said impending cuts to DSH funding, reductions to Medicare reimbursement rates and an imminent increase in the number of seniors hitting the Medicare roster could diminish those improvements if lawmakers and healthcare providers don't work now to address potential problems.

“There are a lot of holes in this bill,” said Richard Pollack, the American Hospital Association's executive vice president of advocacy and public policy. “The coverage expansion didn't go as far as we would have liked. There will still be 20 million uninsured after this bill takes effect.”

In addition to pushing for tweaks to the reimbursement system, panel participants said hospitals also must use the implementation period to aggressively seek out effective care-delivery models that will help them reduce and control costs. “Hopefully, the demonstration and pilot programs will teach us something over the next five years, or else we're going to find ourselves right back in the same place,” said Atul Grover, chief advocacy officer with the Association of American Medical Colleges.

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