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Virginia hospitals to lawmakers: ‘Do no harm’ on healthcare

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healthcareSeveral Virginia legislative leaders have expressed a preference for waiting to see what Washington does before pursuing significant state healthcare policy changes. The Virginia hospital community believes that is a well-reasoned approach given the present uncertainty about the potential impacts of decisions made in Washington.

“Health care policy decisions made in Washington could have a dramatic impact on hospitals, our health care networks here in Virginia, and patients’ access to care,” said Mary N. Mannix, President and CEO of Augusta Health in Fishersville and Chair of the Virginia Hospital & Healthcare Association (VHHA) Board of Directors. “Virginia hospitals already face $1 billion in annual cuts under the Affordable Care Act (ACA), and are likely to continue even if the law is repealed. If the law is repealed without a full replacement, one estimate suggests Virginia stands to lose $2.6 billion in health care spending associated with people newly insured under the Affordable Care Act, and of that amount, hospitals could lose nearly $986 million. Those are significant sums which can have far-reaching implications for patients’ access to health care, and for Virginia’s economy. That is one reason why Virginia’s hospital community is asking lawmakers to ‘Do No Harm’ as they consider health care policy change.”

While uncertainty abounds, this session still presents an opportunity to make meaningful enhancements to Virginia’s health care system. Virginia’s hospitals this session have put forward a robust behavioral health package – to enhance the pre-admission screening process, to create an emergency psychiatric patient registry, and to establish a 24-hour stabilization period prior to a commitment hearing – and support efforts to strengthen cybersecurity standards to safeguard sensitive medical data. Virginia’s hospitals also continue to work with stakeholders on a range of other health care issues, such as combating the opioid epidemic, and enhancing graduate medical education funding.

Finding thoughtful consensus on those items is something to aspire to this session. When considering other major state health care policy reform, such as changes to the Certificate of Public Need (COPN) system, Virginia’s hospital community believes that process should not be rushed or done in haste.

“Health care is not a free market, when you consider that hospitals are reimbursed well below cost for treating Medicare and Medicaid patients, who represent a majority of inpatient admissions at most Virginia hospitals, and that hospitals are required by law to provide emergency care to all patients, regardless of ability to pay,” said Toni R. Ardabell, CEO for Bon Secours Virginia Health System and a VHHA Board Member. “Certificate of Public Need helps offset the charity care inherent in our system, while supporting access to essential health services and helping to control costs.”

Any government health care policy can have dramatic impacts on patients and hospitals. Potential policy changes now being discussed come at a time when Virginia hospitals already face serious financial challenges. Recently released data from Virginia Hospital Information show that 27 percent of Virginia’s acute care, critical access, and children’s hospitals, and more than 43 percent of rural hospitals, operated in the red during 2015. Hospital financial challenges are associated with providing charity care and adhering to government mandates, among other factors.

Speaking about the importance of hospitals as health care providers and economic engines, Hampton Roads Chamber President Bryan K. Stephens noted that Virginia hospitals employ 115,000 people in good-paying jobs, generate $36 billion in economic activity, and spend billions with local businesses.

“Just in Hampton Roads, hospitals contribute more than $25 billion in community benefit and employ more than 23,000 people,” said Stephens. “Our hospitals do important work each day. So we can’t afford policies that harm our hospitals. As a business leader, I believe in the free market. But an honest discussion of COPN requires an open acknowledgement that health care is not a free market because of the rules our government has set up. A free market system requires a level playing field. Repealing COPN would further slant an already uneven playing field.”

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