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NAMS lecture on ACA addresses effect on providers

ORLANDO, Fla. — During the Kenneth W. Kleinman Endowed Lecture portion of the North American Menopause Society 23rd Annual Meeting, Deborah E. Trautman, PhD, RN, executive director of The Johns Hopkins Medicine Center for Health Policy and Healthcare Transformation, discussed provisions of the Affordable Care Act and its affect on providers.

“You and I both know these are old problems that we’re wrestling with, but all of us in our practices are going to have to continue working smarter, figuring out how to do more with less, and continuing to move forward in an imperfect world,” Trautman said during her presentation.

In July, the US Supreme Court ruled 5-4 that the health care mandate was constitutional. It upheld the entire Affordable Care Act, with the exception that the federal government’s power to terminate states’ Medicaid funds is narrowly read.

“The implications of that decision are that the Medicaid expansion for states is now optional. That will have an impact on the number of uninsured that are predicted to gain coverage because of this law,” Trautman said.

“As the law specifies, individuals who can afford to purchase insurance will be required to do so, and if they don’t, there will be a penalty that will be assessed. That penalty will never be more than the premium they would’ve paid in the state exchange, so it would be on par with that, but there would indeed be a penalty. There’s a great deal of criticism about that penalty. Some people think it shouldn’t be there at all; some people think it’s too weak. However, it cleared the path for implementation,” Trautman added.

Impact on clinical care, malpractice

Trautman addressed coverage for prevention and wellness regarding women’s health.

“There’s support for pregnant women and new mothers, and there’s also some controversial support that came out in August. Additional guidelines from HHS include well women visits, screenings, and more controversial have to do with the requirement for insurers to cover contraception and contraceptive counseling,” she said.

Trautman told meeting attendees that despite best efforts, the US spends more money than any other industrialized country on healthcare. However, poor outcomes such as obesity, infant mortality and life expectancy are still an issue.

Also, Trautman said that 30% of Medicare spending is directed toward the last 6 months of life.

“We know from a practitioner’s perspective that’s not the time to be having these critical discussions with people,” Trautman said.

She added that malpractice was not covered in the current law due to the lack of empirical evidence which could demonstrate its benefit.

“On the one hand, you want to believe that evidence drives decision-making, on the other hand we know that evidence does not drive decision-making,” she said.

Common ground

Trautman called for providers to raise awareness on the general issues that would benefit patients.

“Where we can, where there are common areas of interest and commitment, we can come together as healthcare professionals. I believe that at the end of the day it does indeed take all of us,” Trautman said.

Trautman said she is an optimist, and that she believes healthcare reform has made progress.

“I believe that this law is good for our country but many people do not. However, even with the strengths that it has, it is imperative upon all of us to be actively involved as we think about what implementation is moving forward,” she added. – by Samantha Costa

For more information:

Trautman DE. 2012 Kenneth W. Kleinman Endowed Lecture: Changes in the New Healthcare Law & Their Effects on Practitioners. Presented at: The North American Menopause Society 23rd Annual Meeting; October 3-6, 2012; Orlando, Fla.

Disclosure: Trautman has no relevant financial disclosures.

ORLANDO, Fla. — During the Kenneth W. Kleinman Endowed Lecture portion of the North American Menopause Society 23rd Annual Meeting, Deborah E. Trautman, PhD, RN, executive director of The Johns Hopkins Medicine Center for Health Policy and Healthcare Transformation, discussed provisions of the Affordable Care Act and its affect on providers.

“You and I both know these are old problems that we’re wrestling with, but all of us in our practices are going to have to continue working smarter, figuring out how to do more with less, and continuing to move forward in an imperfect world,” Trautman said during her presentation.

In July, the US Supreme Court ruled 5-4 that the health care mandate was constitutional. It upheld the entire Affordable Care Act, with the exception that the federal government’s power to terminate states’ Medicaid funds is narrowly read.

“The implications of that decision are that the Medicaid expansion for states is now optional. That will have an impact on the number of uninsured that are predicted to gain coverage because of this law,” Trautman said.

“As the law specifies, individuals who can afford to purchase insurance will be required to do so, and if they don’t, there will be a penalty that will be assessed. That penalty will never be more than the premium they would’ve paid in the state exchange, so it would be on par with that, but there would indeed be a penalty. There’s a great deal of criticism about that penalty. Some people think it shouldn’t be there at all; some people think it’s too weak. However, it cleared the path for implementation,” Trautman added.

Impact on clinical care, malpractice

Trautman addressed coverage for prevention and wellness regarding women’s health.

“There’s support for pregnant women and new mothers, and there’s also some controversial support that came out in August. Additional guidelines from HHS include well women visits, screenings, and more controversial have to do with the requirement for insurers to cover contraception and contraceptive counseling,” she said.

Trautman told meeting attendees that despite best efforts, the US spends more money than any other industrialized country on healthcare. However, poor outcomes such as obesity, infant mortality and life expectancy are still an issue.

Also, Trautman said that 30% of Medicare spending is directed toward the last 6 months of life.

“We know from a practitioner’s perspective that’s not the time to be having these critical discussions with people,” Trautman said.

She added that malpractice was not covered in the current law due to the lack of empirical evidence which could demonstrate its benefit.

“On the one hand, you want to believe that evidence drives decision-making, on the other hand we know that evidence does not drive decision-making,” she said.

Common ground

Trautman called for providers to raise awareness on the general issues that would benefit patients.

“Where we can, where there are common areas of interest and commitment, we can come together as healthcare professionals. I believe that at the end of the day it does indeed take all of us,” Trautman said.

Trautman said she is an optimist, and that she believes healthcare reform has made progress.

“I believe that this law is good for our country but many people do not. However, even with the strengths that it has, it is imperative upon all of us to be actively involved as we think about what implementation is moving forward,” she added. – by Samantha Costa

For more information:

Trautman DE. 2012 Kenneth W. Kleinman Endowed Lecture: Changes in the New Healthcare Law & Their Effects on Practitioners. Presented at: The North American Menopause Society 23rd Annual Meeting; October 3-6, 2012; Orlando, Fla.

Disclosure: Trautman has no relevant financial disclosures.

    Perspective
    Margery L.S. Gass

    Margery L.S. Gass

    It was an optimistic presentation, and the improvements introduced by the new health care plan outweigh the shortcomings. Clearly, we need to continue to work on the shortcomings of the Affordable Care Act. The Supreme Court approval of the individual mandate is a milestone that will allow us to provide coverage for more Americans. It is time to move forward.

    • Margery L.S. Gass, MD, NCMP
    • NAMS Executive Director

    Disclosures: Gass reports no relevant financial disclosures.

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