Health care reform will likely survive the shift of power in Congress following the midterm elections, but how the plan takes shape and the speed at which it is executed will have real implications for Emory employees, according to a panel of health experts speaking at a recent Emory event.

The panel discussion, held Nov. 3 at the Woodruff Health Sciences Center, brought together experts in clinical operations, nursing, governmental affairs, health policy and insurance to explore the personal and societal implications of the sweeping health care changes signed into law in March.

“What we have here is the unique crucible for the invention of new models of delivery,” said Wright Caughman, interim executive vice president for health affairs and chairman of Emory Healthcare. “The health care system has never had this much attention in our lives and it needs it. We need to get more ecumenical in our approach, not parochial.”

A central element of the reform plan is offering incentives to providers to improve care coordination through “medical homes,” where family physicians lead practice teams with access to comprehensive electronic health records, and patients are active participants in their treatment plans.

Warning: Higher premiums?

“The medical home is the front door to an accountable care organization,” said Penny Castellano, chief medical officer for clinical operations at The Emory Clinic.

While health care reform shows promise, it falls short in improving care quality and containing costs in the near-term, said Mohit Ghose, vice president of public affairs at Aetna Inc., which administers Emory employee and student health plans.

The government’s proposed taxes on pharmaceutical companies and medical device manufacturers, along with reductions in Medicare payments, will be passed on in higher premiums, he warned.

Already, private employers are reevaluating whether it makes financial sense to extend medical benefits to Medicare-eligible retirees, said Ron Fontanetta, a Towers Watson senior health care consultant. More changes to employer-based plans are expected between 2014 and 2018, he said, when health insurance exchanges will be open for individuals to comparison- shop policies and an excise tax will be imposed on high-cost, “Cadillac” plans offered by employers.

While certain areas of the law are more politically palatable than others, scrapping it and starting fresh is unlikely, said John Engelen, Emory’s vice president for governmental affairs.

Republicans now control the House of Representatives, but they don’t have enough votes to overcome a Senate filibuster or president’s veto if they try to repeal the law, he said.

Yet in Georgia, where Republicans captured every statewide office, they could move to halt implementation of a state-level health insurance exchange set for 2014, he added.

View the Nov. 3 health care reform panel

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  Emory Report, Oct. 25, 2010