Implementation of the Affordable Care Act, also known as Obamacare, is set to take effect in 2014, bringing huge changes to the healthcare industry.
Speaking about those changes to members of the Rehoboth Beach-Dewey Beach Chamber of Commerce Dec. 19, Beebe Medical Center President and CEO Jeffrey Fried said there are more good things than bad in the act, although, he said, it tries to do more than what is needed.
“I think what we really needed was to figure out how to provide healthcare to more people that didn’t have it, but also figure out a way to make healthcare less costly,” Fried said.
The primary good thing, he said, is that more people will have access to healthcare services. Unfortunately, Fried said, one problem is there is a lack of primary care doctors in Sussex County.
“Here in Sussex County, we have about half the primary care doctors we really need. So, if we are going to add all these people to the system and give them coverage, it’s only going to be helpful to them if they have access to a primary care doctor,” he said.
To remedy that, Fried said Beebe is trying to bring to Sussex County more primary care doctors and more nurse practicioners and physician assistants.
Another good thing, he said, is the act prohibits insurance companies from denying coverage based on preexisting conditions.
“So if you were sick or had something in your medical history, it meant there were some insurances that would not provide you with coverage," Fried said. As a result, many people were locked into a job and couldn't go somewhere else.
Fried also said provisions that call for more preventative care will lower healthcare costs for individuals and for hospitals. Fried said costs remain an issue, particularly in treating people on Medicare and people with chronic diseases. He said 10 percent of Medicare beneficiaries drive 70 percent of the cost.
“We need to figure out how to better manage those people. We need to change the way our healthcare system is organized to really focus on those people,” Fried said.
He said 50 percent of Medicare money is spent in the last two months of life. Fried said all too often, people wait until it is too late to make a difference and then pull out all the stops to try to save a person’s life. Beebe is organizing teams to help families navigate the healthcare system at the end of someone’s life, he said, but he also acknowledged people need to have those conversations earlier.
Fried called for reforming the payment system for medical services.
“Right now, it focuses on paying people to do things. So the more things we do for people, the more money that’s spent and the more money that doesn’t necessarily get spent in the right way,” he said. “There’s really no continuity. And more importantly, there’s no coordination of care that ties all that together.”
Fried said medical professionals need to better manage and plan patient care, not just during a visit, but over the patient’s lifespan.
In addressing Beebe’s future, Fried said the challenge is to improve availability of medical services as Sussex County’s aging population grows. He said the focus will be on preventative care and screenings, as well as better coordination of services to provide better care.
“We really need to figure out how to bring doctors and hospitals together more closely. Not only in terms of taking care of patients, which we’ve always done, but in sharing financial risk, so we can figure out a way to reduce the cost of healthcare,” Fried said.