Last week, Sen. Tom Daschle appeared at a conference for sehior healthcare finance types. While much of his talk was devoted to inside baseball on reform, he took a moment to urge healthcare executives to get involved directly in the legislative process. “If you don’t know the name of your healthcare legislative assistant, then you aren’t [involved enough,]” Daschle told the crowd.
Unfortunately, it’s likely that his reminder fell on deaf ears. In our experience, few hospital executives get involved directly in politics, though they may support lobbying efforts by trade groups. It’s not just that they’re too busy; many seem to see legislative activism as some sort of specialized skill, like accounting or database programming.
But it’s high time that they change their style
If hospital execs leave lobbying and hand-holding to specialists, legislators may never hear how things are playing out on the day-to-day level, or learn first-hand what kind of messy dilemmas your facility faces. What’s more, there’s nothing like a real-life example to make the case for, say, funding for uncompensated care. (“Here at County General, 23 percent of our patients are uninsured. That saps our finances and endangers our ability to survive. We turned away 147 people from our ED last year and the number may be higher this year.”)
nextHospitals can’t sit idly by and let the so-called professionals handle legislative issues. In fact, getting to know the healthcare LA is just the beginning.
Identify what issues matter most for your facility, find out how you can hammer them home to your political reps, and find a way to communicate your position to everyone that counts. Yes, it will take extra time and staffing, but you already have PR folks, community outreach staffers, business analysts and more. Put politics on their radar: You’ll be glad you did.
That’s what I call “participating.” Doctors who are worried about uncompensated care should also look at Pricing and Payment Arrangements. As a Patient Advocate, I never hear from patients who do not want to pay for their health care. The problem comes from not understanding what they are paying for and options for payment. Because billing is set up to send a simple code for reimbursement, the patient get a bill for a day in the hospital, or for a test or procedure which has a price, then the negotiated price and then their responsibility. Then when the patient calls to ask for an explanantion of the charges, they are routed to a collector who refuses to discuss the charge and will only insist on payment in full. Patients should receive a payment consultation prior to treatment to make sure they understand the charges. Of course in the hospital this may not be possible as much care is provided in emergency situations, but this is not the issue being addressed in health reform. The issue is that patients are neglecting early intervention because they are not welcome at physicians offices without proof of coverage. The health reform proposal seeks to limit the so called Platinum plans. Instead of rationing, why don’t we try retailing?
For those hospitals operating out of new york, the associations (HANYS and GNYHA) do a great job representing the provider market when dealing with federal and state issues. They have staff that are able to reach out to any legislator and speak intellectly about the providers concerns. It is the responsibility of the provider to provide information to these associations and become active in their strategic direction . The results have shown that the power of the group is must greater then the individual provider.
Even if you have no interest in “inside baseball” for hospital legislative issues, I agree that it is important to have an informed voice, and an open channel to legislators, at the individual institution level. The problem with relying on a trade association to do your work for you is that often the association is hamstrung between members in opposing camps on a particular legislative or regulatory issue. While it shouldn’t be this way in an ideal world, in the real world legislative and regulatory changes to hospital reimbursement and other rules and regulations are either a zero-sum game or result in the delineation of two camps: haves and have-nots. It becomes impolitic, if not impossible, for an association to take a stand on issues divisive to its membership. If member hospitals do not have their own systems in place to advance their own interests — whether alone or in concert with similarly-situated institutions, possibly in an ever-shifting series of alliances, depending on the issue — they will find themselves up the proverbial creek without a paddle, as they will have no voice on the issues that matter greatly to them.