I recently participated in meetings in Washington, D.C., that further cemented my belief that changes to healthcare that are enduring are needed in order to make certain that all Americans have access to affordable, quality healthcare. After spending several days meeting with legislators from both sides of the aisle, I truly believe there is an opportunity to do this in a bipartisan manner.
As the Senate works to develop its own version of the American Health Care Act, there is an opportunity to craft legislation that stabilizes the individual market, stems the tide of rising premiums and health plan withdrawals, and continues to ensure affordable, accessible care for all. At the end of the day, any legislation that goes to the president for his signature must increase access to affordable and quality care, not reduce it.
After spending some time in our nation's capital, I can see the outlines of potential bipartisan support. For example, both Republicans and Democrats agree that any legislation should continue to offer protection for individuals with pre-existing conditions, something we at Ascension wholeheartedly support.
Moreover, the Senate Finance Committee recently approved the CHRONIC Care Act with all the Republicans and Democrats on the committee joining together to move that bill forward. And both parties have also participated in meetings to discuss health reform, acknowledging the individual insurance markets need repair—again an issue with broad support. These developments offer new hope that bipartisanship could emerge in this important debate.
At Ascension, the nation's leading not-for-profit health system, we are committed to ensuring that healthcare is accessible and affordable as we deliver on our mission of providing compassionate, personalized care to all, with special attention to persons living in poverty and those most vulnerable. We, along with our colleagues in the healthcare industry, are closely watching to see how any new healthcare reform legislation will affect those who benefited from the Affordable Care Act while also working to improve upon those elements of the law that are not working well today.
I believe there are three guiding principles that respond to the urgent needs in healthcare at this time and will move the country toward a sustainable, efficient and value-focused system of healthcare.
First, we need to strengthen and stabilize the individual insurance market to best serve all Americans. The market should be available to each individual and not discriminate against anyone based on their health status or because of a pre-existing condition. Maintaining a system where those with chronic conditions and more significant healthcare needs receive continuity of coverage and care helps ensure that everyone has affordable access regardless of their health status.
For a market-based system to work effectively, there needs to be a wide range of enrollees, including younger and healthier people, to spread the risk and help keep premiums and out-of-pocket expenses affordable. It must also be an urgent priority to fund the cost-sharing reduction subsidies in the near term, to serve the dual purpose of making healthcare affordable for low-income Americans and to lower premiums for all enrollees.
Second, we need to preserve the safety net for those who need it most. Increases in coverage have helped ensure the working poor have access to affordable healthcare. It is critical that Congress preserve coverage for the more than 15 million newly enrolled people who have received health coverage in recent years and also preserve the option for states that have not expanded Medicaid to increase coverage. Congress should take steps to preserve the safety net instead of enacting Medicaid cuts that will do serious harm to healthcare access for the vulnerable.
To best reduce costs, Medicaid should be moved from the current fee-for-service payment models to those that reward value, including within Medicaid managed care. States should be given the flexibility and incentives to test and implement value-based payment models and make strides to improve population health outcomes for patients while sharing in the savings that their efficiencies produce. Medicaid should be a federal/state partnership to keep those who are poor and vulnerable healthier and achieve sustainable cost savings in a strong safety-net program.
Finally, it is essential that we support the continued transformation of healthcare delivery. Any potential action to fix what is not working today must consider its impact on the resources needed to invest in the journey toward value. Given the unsustainability of our current level of healthcare spending, we should prioritize and preserve resources that enable us to move to value-based payment models as quickly as possible. Payment models that reward care coordination, prevent unnecessary hospitalizations, focus on population health and improve quality are the key to achieving lower costs in the long run.
Anthony R. Tersigni is president and CEO of St. Louis-based Ascension.
