December 6, 2013

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December 6, 2013

What do hospitals and doctors provide now? Well, we provide sick care, primarily. If more people enroll in the system, we’ll be able to alter the product that we deliver. Is the product that St. Mark’s delivers today—surgery and imaging and ER work—is that what is really needed when the pool gets bigger in five, 10 years from now? Probably not. It will be different if more people will enroll. And they’ll have access to wellness and we’ll be able to predict the demand better and the efficiency of the system will improve.

Do you have any further thoughts about the Affordable Care Act, anything that will help people understand it better?

HOWARD: In the brokerage community here, we deal with thousands of employers, thousands. One thing that’s very consistent is that leaders of these companies want to get the cost down. They really have to do something to get the cost down or else they’ll go out of business. They’ll lay off people. They won’t be able to hire as many people as they need. So they’re asking us to help educate these employees.

We talked about transparency, consumerism, things that employees need in order to make good buying decisions. What they are consistently trying to avoid with their employee groups is don’t go to the hospital unless you absolutely have to. Don’t go to the ER unless you absolutely have to. Go to urgent care. Try to get it taken care of less expensively. Really look at the costs of where you’re going.

Education is the key here. Everyone needs to educate the employees, the people in this community on what they need to do to manage their costs and where they go to get the best care and control these dollars.

KEVIN JOHNSON: One of the biggest questions is how are we going to pay for this long term, and how is it really going to be affordable at some point in time for everybody with all this expansion. With the hospital industry, we agreed to give up a lot of reimbursement on the Medicare side over the next 10 years to help fund some of this, so we’re counting on this system working and getting more people insured so that we’re not cost shifting as much.

There are some really good things about the Affordable Care Act. Covering children up to age 26 has been a great thing for students, and I have kids that fall into that category. It’s been a good thing for them to be able to have that transition period, and I’ve got some of them now that have transitioned off as they’ve gone into better-paying jobs that have insurance.

As hospital providers, we’ll continue to look for ways to reduce costs as well. We’re looking at telemedicine and those kind of things in some of the smaller hospitals and rural hospitals to be able to still provide high-level care but without having to recruit extra providers to do that. We can tap into the people that are already existing in the community but do it through telehealth.

HURST: Bob hit it on the head: education. We’ve held nine seminars in 2013 on the topic of healthcare reform. Employers are hungry for information to understand healthcare reform and how it’s going to impact them. Bottom line, we need to come together as a community and find ways to really educate people on this topic. Because candidly, they’re deer in the headlights.

BOSWORTH: With 211, we actually hear the voices of the Utahns who are challenging us and asking us questions and are looking for trusted sources. But many of our callers are used to going to the emergency rooms. They’re used to tapping into the emergency clinics. And I don’t see that changing even with insurance benefits. I see people in the short term going where they feel comfortable and where they feel they can trust someone. And for a lot of people, that is their emergency room. That is their medical home.

So ensuring that we provide opportunity to educate people about the different resources, different places that are that next step into the next level of coverage and where they can go and still feel safe within that environment, we’re certainly working on that with 211 to let people know of those options.

 LANGELL: I want to emphasize the education piece but at a different level. Clearly one of the most pressing domestic issues we have is healthcare and healthcare reform, and how do we continue to pay for the care of our individuals. But our education is focused now on employers and folks going out there and actually getting their insurance. And they’re drinking from a fire hose, very quickly trying to figure out what to do.

We’ve mentioned that it’s really important to get the young involved, because they’re the ones who are going to offset the care so that those with the greater expenses are being subsidized through their care, and as they migrate through the system they’ll get subsidized. So this is an opportunity to grab a community that is already captive for education. We should be doing this at the high school level. We should be doing this at the college level. Because these kids in high school, they hit 18 and they get out, they’re in this community we’re talking about. And now you’re asking an 18-year-old to really learn about life outside of the family environment, and you’re asking them to do this and to navigate these issues. We should have educated them well before this, not just on the options, how exchanges work, how insurance works—but if you seek healthcare in an emergency department it costs a lot. If you go to a primary care physician, they have time to work things out smoothly over time if it’s safe and not an emergency.

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