What will the next four years look like?

In the days since Donald Trump was elected President, many have speculated about the future of the Affordable Care Act (ACA) and what it will mean for health care organizations. I have attended several seminars and spoken with a number of experts; however, no one in health care or politics is exactly sure what will happen next.

There is a great deal of discussion about repealing and replacing the ACA. However, the Trump administration has also signaled that it does not intend to repeal all parts of the law. The provisions allowing children to remain on their parents’ health insurance until age 26 and prohibiting insurance providers from denying health insurance because of pre-existing conditions probably will remain.

One of the biggest questions involves the future of Medicaid expansion. Some of you have heard me talk about how important Medicaid expansion is to health care in the Mid-South. Tennessee and Mississippi have chosen not to expand Medicaid, and during the past five years, a number of hospitals in those states have been closed or sold, leaving underserved communities even more disadvantaged.

The future of Medicaid expansion is unknown; President-elect Trump and the incoming Congress seem to favor giving money to each state in the form of block grants, allowing the states to decide how to distribute it. That could reduce the number of individuals covered by Medicaid and increase the amount of uncompensated care we provide. Additionally, many experts believe that the ACA-mandated Medicare cuts will remain intact.

Despite this uncertainty, I am optimistic about our future. Some aspects of the ACA have nearly universal support, and we have been developing programs around those provisions for quite a while.

The likely changes to the ACA will require even greater alignment between physicians and health care organizations. Our strategic plan addresses this. The federal government is expected to continue supporting programs like our Transforming Clinical Practice Initiative and the Oncology Care Model. Bundled payments – when all providers involved in a patient’s care coordinate efforts and deliver only one bill to the patient – are also popular with Congress and the new President. We recently unveiled a bundled payment model for our orthopedic services, and we will begin offering bundled payments for our cardiovascular services next year.

In addition to staying on top of emerging health care trends, we’re also working hard to ensure our voices are heard. We will continue to meet with local, state and national legislators and partner with other health care organizations through the Tennessee, Mississippi, and Arkansas Hospital Associations to let our political leaders know how their decisions and votes will affect our patients and communities.

If you feel passionately about this or any other issue, I urge you to do the same. We must all participate in the political process and advocate for the issues that are important to us.

For the past 104 years, amidst tremendous change in our country and our communities, Baptist has been a fixture in the Mid-South, providing exceptional care guided by our mission, which mirrors the three-fold ministry of Christ—healing, preaching and teaching. As long as we keep working together as a team to meet our patients’ health care needs, that will never change.

We will not be sending an issue of Leader next week, so I wish you and your family a very happy Thanksgiving. As always, if you have any thoughts or questions for me, please email me, tweet me @jason_m_little or find me on LinkedIn.