Whitaker said while the other panelists spoke about the “Affordable Care” aspect of the act, he would talk about the “Patient Protection” aspect. He said the new health care law is still evolving, and about 45 percent of the regulations and 50 percent of the law has not been proposed yet.
“I think early on, the changes you will see will be based on the coverage you have,” he said. “I encourage everyone to have actual conversations with your employer and your insurance provider.”
Medicare will continue the shift toward outpatient treatment. That trend has been in effect for four years, Whitaker said.
Accountable care organizations will be assigned for total outcomes of care. People seeking providers outside of the ACO will have fewer benefits, he said.
Medicaid will expand with 17,000 newly eligible persons in Cleveland County alone.
“Who is going to take care of them?” Whitaker said.
Many doctors don’t take Medicare and Medicaid patients, but for the hospital, this Medicaid expansion will be a plus.
“We’re taking care of them right now,” he said.
The hospital serves everyone, regardless of ability to pay. Now there will be reimbursment for more of those people, adding $9 million to $11 million in revenue.
The uninsured should be looking ahead, but often they are people who have the fewest resources to research their options, Whitaker said.
“They need to be preparing,” he said. “They need to be researching.”
Another trend is many doctors are discontinuing their hospital coverage, allowing the hospital group to treat patients once they have been admitted. Whitaker said it’s important for residents to find out if family doctors will still treat them in the hospital setting.
Changes will be required at Norman Regional Health System for it to survive the next five years, he said. Those changes include improved efficiency and outcomes, reduction of operating costs and improved patient experience.