Modern Healthcare reporters are tracking healthcare leaders' reaction to President Barack Obama's re-election and what the election means for the healthcare industry, which finally has certainty that the bulk of the Patient and Protection and Affordable Care Act will be implemented yet little clue how the president and a still-divided Congress will treat healthcare programs in their quest to control federal spending. Modern Healthcare will continue to update this page throughout the week.
Dr. Delos "Toby" Cosgrove, president and CEO, Cleveland Clinic (interview):
“I don't think there is any question that we have a healthcare bill and the healthcare bill won't be repealed. It's incumbent on us as providers to figure out efficiencies."
Anya Rader Wallack, chair, Green Mountain Care Board, which is responsible for establishing a single-payer health plan in Vermont (interview)
: “We've been actively implementing the ACA and this is good for us (Vermont) in the sense that we know now we can continue on in the path that we've been moving on with greater certainty that we have a federal partner. … The outcome of the election affects more the short-term planning around the interim steps before we get to Green Mountain Care.”
Warner Thomas, president and CEO, Ochsner Health System, New Orleans (interview):
“We have more certainty about what's going to happen. We did not change anything (ahead of the election), we just continued down the same path understanding the healthcare reform bill would be retained for the most part anyway. The thing I'm going to be concerned with is how Congress is going to deal with the fiscal cliff. We're concerned about the expense cuts and where they're going to occur.”
Dr. Gary Kaplan, chairman and CEO, Virginia Mason Health System (interview):
“I expect the act to essentially remain intact. There may be some fine-tuning around the edges, but I don't see the fundamental elements of the (Affordable Care Act) going away and I think IPAB will actually end up staying—it's a very important component of the bill.”
Dr. Robert Laskowski, president and CEO of Christiana Care Health System, Wilmington, Del. (interview):
"We've always been great supporters of the Affordable Care Act and the principle that it embodies; there's always a few things in there that could be improved but overall the direction is clearly the right way. What the election did was clarified and made our lives simpler. … In the longer run the direction of the necessity for us to pay attention to value, to improve care and to make sure that the care is affordable to all citizens in the country—that was going to be independent of the results of the election. But there would have been rhetoric changes if the election had been different, and it would have slowed us up in the work that we need to do. So we're happy for the clarity and think that taking care of our neighbors is vitally important.“
Lloyd Dean, president and CEO, Dignity Health (interview):
“We think that healthcare in a country like ours is something this is a right as opposed to a privilege. We have been, as you know, supporters of the ACA because we acknowledge that right and we believe through the results of the election that momentum and actions will continue to full implementation of the act. We continue to believe that this will allow us to do something that is very important, which is to address and bring forward solutions to the national healthcare crisis in our country. … One thing there is no debate about on either side of the political spectrum is that the current status of healthcare, prior to some type of reform, was not sustainable. … Even if the act itself had been modified severely, we would still move forward with what we think is important to figure out a way to reduce costs, improve efficiencies, to raise the bar for quality and to increase access.
Dan Slipkovich, chairman and CEO, Capella Health (interview):
“There's still an awful lot that we're dealing with. … The near-term concern for us is the proposed cuts that are out there. The concern is that with the fiscal cliff, we're going to see more arbitrary cuts. We really need to deal with some long-term solutions.”
Susan DeVore, president and CEO, Premier (statement):
“Now that the elections are behind us, we need to, on a bipartisan basis, get back to the task of removing the barriers to transforming healthcare. The payment and delivery reforms in the Affordable Care Act provide a framework to move us in the right direction. We need to build on those reforms to align payment incentives and measurement with effective patient care. Patients and healthcare providers will be harmed by continual payment cuts unless we empower providers with the flexibility to improve care and drive out waste.”
Dr. Brent Eastman, president, American College of Surgeons (interview):
“My great hope, and the hope of the American College of Surgeons, is that there will now be a spirit of bipartisanship in Congress to figure out how to fix those things that broken in our healthcare system. … It may sound simplistic, but we have to be at the table. We've got to speak forcefully about what works and what doesn't work and it must be in the context of what is in the best interests of our patients. There are great challenges ahead. But, if in things political, if we always base our decisions on what we believe is best for our patients, we will never be wrong.”
Dr. Donald Berwick, former CMS administrator under Obama, senior fellow at the Center for American Progress (interview):
“If Congress reads this as an endorsement from the public of healthcare reform, I'm hoping we can move into a phase of further exploration and adjustments of the law. However, the current breakdown between the House and Senate remains the same so the risk is if the opposition remains intransigent and uses funding to starve the implementation processes. … I hope that all of the states come on board (with the ACA's Medicaid expansion). The people who would be covered under the expansion are getting care now—they're just getting it late, when they're sicker and their care is more expensive. For the states that turn down this money, it doesn't solve their problem. It increases states' burdens to care for these vulnerable people. It's an unwise policy and it's an incorrect moral stance.”
Richard Umbdenstock, president and CEO of the American Hospital Association, (interview): "I think the election clearly indicates the ACA will move forward, so we've got to work on the implementation thru the regulatory side and we'll look for opportunities to improve it on the legislative side."
Dr. Doug Curran, family practice physician in Athens, Texas, and member of the board of trustees for the Texas Medical Association (interview): “I personally don't think it makes much difference. Healthcare is changing, and it's OK. … I think docs frequently tend to get down and depressed about stuff that's not going their way. I hope they can keep a positive attitude.”
Sister Carol Keehan, president and CEO, Catholic Health Association of the United States (interview): “I think what this victory means is that we can continue the roll out of the Affordable Care Act, which is really critical. The Affordable Care Act strengthens insurance coverage for people who had insurance coverage, but it was inadequate coverage. It did a number of things to strengthen the Medicare program—both the viability and availability of these services and the drug program. In 2014, we really begin to address the 48 million people who don't have anything. The bill is intended to facilitate getting coverage for the 30 to 32 million of them by expanding Medicaid and with the exchanges. The president's victory means we stay on course do to that. And obviously, CHA's been a support of the Affordable Care Act from the start. … This is the first chance in certainly 80 years that a large number of Americans who don't have health insurance—and don't have access for healthcare, for the most part—this is the first time that we see on the horizon for an opportunity to change that. That's a very worthy goal for this great nation.”
Karen Ignagni, president and CEO, America's Health Insurance Plans (statement): “As the healthcare reform law is implemented, policymakers must prioritize affordability for consumers and employers. Several provisions in the law, such as the new premium tax, minimum coverage requirements, and age rating restrictions, need to be addressed to keep coverage as affordable as possible and ensure broad participation in the system. The nation must also address the soaring cost of medical care that is driving up the cost of coverage, taking up a greater share of federal and state budgets, and threatening the long-term solvency of our nation's public safety net programs."
Dr. Robert Wachter, chief of the division of hospital medicine, University of California, San Francisco (interview): “I wouldn't be surprised if some of the money for (the Center for Medicare and Medicaid Innovation and the Patient-Centered Outcomes Research Institute) is cut a little to reach a deficit deal, but the program elements will not go away. … The objections to the CMMI and other programs came from a wing of the Republican Party that today is licking its wounds and questioning if a strategy of saying no to everything is a good one.”
Dr. Nicholas Wolter, CEO, Billings (Mont.) Clinic (interview): "I think there's a little more clarity about healthcare reform, and we have some sense of that staying in place--and I think that's helpful as we progress and work on the value equation and all the initiatives around quality and cost that everyone is working so hard on. … Some of us felt it would have been hard to repeal the ACA, but (if Romney had won) there would have been at least some attempt to undo parts of it using administrative approaches."
Jon Glaudemans, chief advocacy and communications officer for Ascension Health (interview): "The election indicated that the ACA is here to stay and that we all need to get on with the work of implementing it to the letter and spirit of the law. We at Ascension are looking forward to working with the administration, the statehouses and governors to ensure Medicaid expansion is adopted across the country, as well as the various other initiatives related to value-based payment systems, the emphasis on quality and patient safety and the focus on collaboration between physicians and hospitals to pursue the seamless care of individuals and their families. Internally, we've always based our strategic planning on the fact that many of the important decisions with respect to expanding coverage and fostering innovative models of care was going to happen on the state level, and that would have been true under a Romney administration and it will be true under an Obama administration. In that regard we think the state will continue to be asked to play a leadership role in expanding coverage and transforming our delivery systems and we hope to work with those governors and statehouses to see this happen in 2013 and beyond."
Dr. Dean Gruner, president and CEO, ThedaCare, Appleton, Wis. (interview): "Now (the president and Congress) have to decide whether sequestration is the best work they can do or if they think they can do better work together. If they think they can work together, they'll have to put all issues on the table. That's why I'm not thinking that it's absolute that all portions of the Affordable Care Act will proceed."
Stuart Guterman, vice president and executive director, the Commonwealth Fund's Commission on a High Performance Health System (interview): “There's been lots of talk in health policy circles about what happens if who wins. But regardless, we face the same problems. The difference is that the ACA provides some of the tools to address some of the big problems the healthcare sector faces. The challenge is still figuring out how to use those tools to improve the system and control costs. … The bottom line is there will be arguments about the scale of Medicare and Medicaid and how they should be financed. But I hope health policymakers will focus on health spending and making healthcare work better for all of us. That's not a partisan issue.”
John Fraser, president and CEO, Methodist Health System, Omaha, Neb. (interview): "The change itself would've happened regardless (of who won). … I don't know about certainty, but at least there's reliability and some predictability to evolve from a volume-based system of care to one that is value-based. It really doesn't change our plan. We wanted to develop our accountable care structure regardless of who got elected.”
Dr. Jeremy Lazarus, president, American Medical Association (statement): “This is a critically important time for our healthcare system, and America's physicians remain at the forefront of policy discussions, working with President Obama, members of Congress and the administration to focus on the important task of improving both the delivery of healthcare and the health of our nation. … The AMA is also committed to working with Congress and the administration to stop the nearly 27% cut scheduled to hit physicians who care for Medicare patients on January 1. It is time to transition to a plan that will move Medicare away from this broken physician payment system and toward a Medicare program that rewards physicians for providing well-coordinated, efficient, high-quality patient care while reducing healthcare costs."
Dr. Bruce Siegel, president and CEO, National Association of Public Hospitals and Health Systems (statement): "As the president turns to the important work ahead for healthcare, deficit reduction and other challenges, NAPH offers its support as a resource for his administration and Congress. … We appreciate the administration's continued attention to the needs of safety net hospitals, which provide care to all, regardless of ability to pay. Achieving healthcare reform's goal of broad coverage expansion must remain a national priority, for the good of patients and the country's future."
Ron Pollack, executive director, Families USA (statement): “The election has settled key issues about the directions that our nation's healthcare will take: It means that Obamacare will be implemented, the Medicaid safety net will be strengthened, and Medicare's guaranteed benefits will not be undermined. … An important challenge also lies ahead now that states can expand their Medicaid programs to more low-income adults. To enable this to happen, the federal government is providing unprecedented fiscal support to the states: 100% funding of expansion costs in the first three years and never less than 90% thereafter. This guarantee is essential for governors as they decide whether their programs should cover more low-income adults. It is therefore crucial that upcoming federal budget decisions give governors clear assurances that this funding is stable and won't be reduced.”
Mike Duggan, CEO, Detroit Medical Center (Crain's Detroit Business): "It means healthcare reform will go forward—means that 500,000 people (in Michigan) will have healthcare who didn't have it before.”
Mark Parkinson, president and CEO, American Health Care Association (statement): “While we know that the president and our newly elected Congress must find ways to reduce federal spending and fund a wide variety of programs, now is the time to take a hard look at meaningful reforms to solve the issues that face both the Medicare and Medicaid programs. Stable Medicare and Medicaid funding will help ensure America's seniors continue to have access to high quality long-term and post-acute care."
Dr. Jeffrey Cain, president, American Academy of Family Physicians (statement): "The American Academy of Family Physicians looks forward to working with President Barack Obama and the new Congress to ensure that everyone in this country can get the right healthcare at the right time from the right professional. That means continuing to work for access to both healthcare coverage and to the primary-care physicians who should be the front door to our healthcare system."
Steve Summer, president and CEO, Colorado Hospital Association (interview): “I think, hopefully, we'll get to a little bit of stability and some sanity in our conversations about healthcare reform.” Regarding the expansion of Medicaid: “We're thrilled to the extent that now we can move forward.”