The political and legal challenges to federal health reform may finally be settled with the reelection of President Obama and the Supreme Court’s upholding of the Affordable Care Act, but even with that seeming sense of finality, a host of challenges lay ahead for all levels of the health care industry.
From insurers and providers to local and national brokers, every sector can expect one constant — uncertainty. That’s according to local experts who will discuss post-election health care reform, and how it impacts the local market, at the Business Journal’s annual Health Care Conference on Wednesday.
As a result of health overhaul, hospitals across the country are bracing for significantly lower reimbursement rates from the federal government for Medicare patients, a development that is forcing large health systems to reevaluate their care models and prompting a palpable shift toward more integrated care.
Employers, meanwhile, face a host of complex issues themselves. With state and federal health exchanges — where both employer groups and individuals will be able to shop for what is hoped to be more affordable health coverage with government subsidies — coming online in the next two years, will those same employers drop health coverage for employees? And if so, will those employees be able to obtain affordable, quality coverage?
“This is a primary question that most benefits broker lose sleep over,” said David Hodges, vice president at Vantreo Insurance Brokerage. “The over-burdensome administration of the ACA will lead some small employers with low profit margins, and mid-sized employers with easily replaceable, non-highly skilled workers, to cancel health insurance.”
Similarly, health plans are shifting quickly, often aligning themselves directly with providers to form accountable care organizations, better known as ACOs, or ACO-type structures to prevent costly duplication and more streamlined care. The impact of such structures is not yet known, providers and health plans said, but it’s nevertheless a reality that is emerging on both a local and national level.
And new forms of technology — such as the continued march toward electronic health records — are impacting health care delivery across the country, but concerns center on patient privacy and a host of other issues.
The conference will consist of two panels that will address these and other topics as the Affordable Care Act is rolled out over the next several years. The first panel will include local insurance brokers with expertise in employee benefits. Panelists include: John Fradelizio, managing director, employee benefits, with Wells Fargo Insurance Services in Petaluma; Michael Parr, an employee benefits agent for NorthWest Insurance Agency, a subsidiary of Santa Rosa-based George Petersen Insurance Agency; Jim Settles, senior vice president and partner with Woodruff Sawyer & Company in Novato; David Hodges, vice president of Santa Rosa-based Vantreo Insurance Brokerage; and Victor McKnight, a principal with EPIC Insurance Brokers and Consultants in Petaluma.
The second panel consists of providers and experts from health plans. Panelists include: Todd Salnas, chief executive officer of St. Joseph Health, Sonoma County, which owns Santa Rosa Memorial Hospital; Mike Purvis, chief administrative officer of Sutter Medical Center of Santa Rosa; Rick Heron, chief marketing and brand officer for Sacramento-based HMO Western Health Advantage; and Dennis Lum, vice president, channel strategy, sales operations and performance for Kaiser Permanente Northern California.
The conference will be held Wednesday, Nov. 14, 7:30–11:30 a.m. at the Hyatt Vineyard Creek Hotel & Spa in Santa Rosa. The conference will also include the second Healthiest Companies in the North Bay Awards, presented by the Business Journal in conjunction with the Northern California Center for Well-Being. Register by calling 707-521-5264 or online.
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