“This is going to turn out to be a real money-saver as we start to think about early interventions and coordinated care for a lot of people who are chronically ill and very expensive,” Durbin said about the program.
Dr. Ram Raju, CEO of the Cook County health system, said in an interview that the program aims to ensure the enrollees—many of whom already receive charity care from the hospital—receive the maintenance care needed to keep them from expensive emergency department visits and hospitalizations.
“It means we are responsible for them both inside and outside the hospital,” Raju said.
Durbin's praise for the Cook County program reflects his party's long-held insistence that the Patient Protection and Affordable Care Act will eventually reduce healthcare costs as its initiatives are implemented and should shield Medicare and Medicaid from major cuts as lawmakers have haggled over ways to resolve a series of budget stalemates.
Specific promises of savings from the Affordable Care Act have emerged as the first line of defense for many hospitals and their advocates during the post-election fight for savings to offset the cost of eliminating looming tax increases and Medicare cuts.
During a Nov. 29 briefing for congressional staff, Rebecca Ryder, president and CEO of Franklin Memorial Hospital, Farmington, Maine, repeatedly highlighted cost-saving initiatives at her facility that have cut emergency department spending by 7% during the past 12 months.
“For the Medicare and Medicaid program, the cost has gone away because we are seeing those patients through primary care, a much cheaper setting,” Ryder said in an interview afterward. “There are ways to begin to quantify what everyone is doing.”
Hospital advocates bolster their argument with warnings about how hospitals and their communities would suffer under further cuts in reimbursement from the programs.
“What the fiscal cliff discussions bring to the table is the potential of more and significant cuts in a variety of arenas that could literally destroy the ability of many healthcare systems to deliver healthcare services at a high-quality level, and that is no exaggeration,” Kenneth Raske, president of the Greater New York Hospital Association, said in an interview.
Raske's group joined the Service Employees International Union last week in running ads in Washington newspapers warning about the consequences of cuts in Medicare graduate medical education and hospital evaluation and management services.
An American Hospital Association lobbyist said his group is focused on fighting the proposed $7 billion evaluation and management cut because it was receiving the most attention as a potential offset to avoid coming cuts. Physician advocates also have joined hospitals in fighting cuts to graduate medical education, citing concerns that medical school graduates have started to exceed the number of available residency slots for the first time.
Hospitals also have emphasized that they continue to absorb $155 billion in cuts over 10 years required by the healthcare overhaul and can ill-afford more cuts.