Local business leaders heard from a panel of experts as to what they see for the future of health care at a Charleston Regional Business Journal Power Breakfast event Thursday. (Photo/Kim McManus)

By Lauren Ratcliffe
lratcliffe@scbiznews.com
Published July 19, 2012

When the Affordable Care Act is fully implemented in 2014, changes will ripple throughout all industry sectors.

Local business leaders heard from a panel of experts as to what they see for the future of health care at a Charleston Regional Business Journal Power Breakfast event Thursday.

“This is such a complex and convoluted law that we are dealing with,” said Jim Deyling, president of BlueCross BlueShield of South Carolina.

David Dunlap, CEO of Roper St. Francis Healthcare, agreed.

“If anybody professes to understand the ACA (Affordable Care Act) and thinks they fully understand it, they are either the smartest person on earth or are delusional,” Dunlap said.

Dunlap and Todd Gallati, CEO of Trident Health, said many changes have already begun to occur, not as a result of the legislation, but because of market considerations.

“What we’re working on is creating that value,” Gallati said, after half of the audience said they thought they were receiving quality care for their money.

“I think outcomes can be improved and costs can come down,” he said.

The United States spends twice as much as other developed countries and has the lowest life expectancy among comparable nations, Gallati added.

“I’m embarrassed by that,” he said.

Audience questions addressed concerns that quality of care is being sacrificed and that premiums and costs aren’t actually going to come down with health care reform.

Dunlap and Gallati said quality of care is already shifting due to practices surrounding quality assurances.

Hospitals and providers must achieve certain levels of quality assurance to receive additional reimbursement funds from insurers, Dunlap said.

Tony Keck, director of the Department of Health and Human Services for South Carolina, said he envies hospitals and providers who can work with relative flexibility to address payment problems and new ways to care for patients at lower costs.

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Deyling said S.C. BlueCross is now reimbursing for some services done at ambulatory surgery centers instead of hospitals because providers showed the insurance giant how they were safe and effective in mitigating costs while providing quality care.

Keck said employing similar solutions for Medicaid, or to target specific health issues in the state’s population would require waivers and negotiating with the federal government.

“I would like to be able to work on these hot spots but the Medicaid program federally makes it very difficult,” Keck said. “I have to spend two years convincing the feds that (a suggestion) is a good idea while our people are dying.”

The panel all agreed that small- and medium-sized businesses have a role to play in the reform of the health system.

All of the panelists insisted that instilling priority of healthy choices, in addition to improving access to care, is essential to eventually bringing costs down.

Keck said finding ways to help people have access to jobs, education and encouraging healthy lifestyle choices could make a big impact.

“There are many other things that are keeping people healthy other than our health system,” Keck said. “All we (the government, providers and insurers) can do is treat it. It gets fixed by you, what you can do with carrots and sticks to get people to take care of their own health.”