Archived Publications eBook: The Dollars are in the Details | Page 5

AS CLIMATE CHANGE PORTENDS A RISE IN TEMPERATURE AND THE RISE OF
OCEANS, THE FUTURE OF THE U.S. HEALTHCARE ENVIRONMENT FACES ITS OWN
SEA OF CHANGE. REPEAL… REPLACE. DECLINING INPATIENT ADMISSIONS…
OUTPATIENT GROWTH. HIGH-TOUCH MEDICINE… TELEHEALTH. THESE OPPOSING
PARADIGMS SIGNAL HUGE CHANGE AHEAD.
For a bird’s-eye view of the current climate and a forecast of what’s
ahead, we spoke with Joanne Aquilina, CFO at Bethesda Health in
South Florida. Ms. Aquilina’s point of view has been honed through
more than 20 years in hospital financial management and over 10 years
of public accounting. Covering a wide range of topics, she focused
on several key factors affecting healthcare today and tomorrow.
ACA’s Cloudy Future
While little in healthcare is a certainty, the new
administration’s effort to repeal and replace the Affordable
Care Act has created a firestorm of partisan infighting
in Washington. Ms. Aquilina believes resolving concerns
about the government’s healthcare policy is the number
one challenge for hospital CFOs and CEOs, adding
“Whenever we have an unknown of this magnitude
that will have a huge impact on our bottom line and
ability to budget revenue, it’s a little scary.” She describes
herself as being in the waiting and watching mode, adding
that “something will definitely change, whether the
government scraps the entire program or modifies
what we have.”
She notes Florida’s hospital leaders “are a bit on edge facing
the unknown of the new state budget and Medicaid
reimbursement rates.” Governor Rick Scott remains
opposed to Florida becoming an expansion state, believing
the state can manage Medicaid more effectively than
the federal government. In a recent CNN commentary,
Governor Scott asserted: “If Florida is given the flexibility to
run our own Medicaid program, we will be more efficient
and less wasteful than the federal government.” Given this
view, hospitals in Florida and the other eighteen states
opting out of expansion will continue to operate in an
uncertain environment.
Further complicating the situation is the decision of one of
Florida’s largest insurers to pull out of the federal exchange.
Ms. Aquilina explains that “Humana is a big provider in
our market, but they’re pulling out in 2018,” meaning the
significant population of Humana covered lives in Florida
will be left wondering what will happen to them on
January 1, 2018. Two big players remain in the Florida
market: Blue Cross Blue Shield and Molina, a managed plan
for Medicaid patients. “At least our community still has
options, unlike some areas of the country. For example,
Tennessee has a huge issue because, Humana – the only
remaining exchange plan in that state – is exiting there,
too. Tennessee exchange participants may not have any
coverage in January,” she adds.
As a hospital CFO, she must also address the problem of
patients presenting in Bethesda ERs who fall between
Medicaid eligibility and an exchange or private insurance
policy. She notes that her health system provides services
to those patients on an emergency basis with no realistic
expectation of payment.
HealthStream.com/contact • 800.521.0574 •
Reprint from JUL 2017 PX Advisor
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