Health care reform is happening within the UCLA Health System, but it is not necessarily President Barack Obama’s bill driving the reform, administrators say.
In a presentation to the UC Board of Regents on March 17, John Stobo, the UC senior vice president for health sciences and services, emphasized that the UC must address spiraling health care costs regardless of the fate of the bill, which has been threatened with repeal by Republicans.
“My feeling is that (the bill) is not going to be the major driver (of UC hospital reform),” Stobo said in an interview this week. “The driver is that the cost of health care is unaffordable for patients, doctors and insurers.”
Obama’s bill, the Affordable Care Act, creates a framework to provide insurance for the 33 million Americans that are currently uninsured.
Although passed just over a year ago, the bill is on track to be implemented by 2014. Among other efforts to provide Americans with health insurance, the bill has already ensured that people with pre-existing conditions, such as diabetes, are not denied health insurance.
The UCLA Health System recently hired 40 more primary physicians to account for expected increases in insured patients, said David Feinberg, associate vice chancellor and CEO of the UCLA Hospital System.
Outside the bill’s plan, the UCLA Health system has worked in the past year to address the rising cost of health insurance to bring down costs for patients and insurers.
While these efforts to provide the best care are in line with the bill, the new emphasis on coordinating care is a result of the rising costs of health care, Stobo said.
The Pediatric Medical Home Program and a program to reduce readmission rates for patients with congestive heart failure are two examples of initiatives in the UCLA Health System that surfaced in the past year in the spirit of reform. These programs track patients ““ children and seniors alike ““ in their homes to make sure they follow recommended medication and diets so that they are not readmitted into the hospital, Feinberg said.
In addition, UCLA hospitals are adopting a consultation system so that physicians in the community can contact specialists for free over a secure Internet connection. This way, patients are only sent to the hospital when necessary or remain with their primary physician when a specialist is not needed, Feinberg said.
UC Health has created the self-funded Center for Health Quality and Innovation to support new health care programs such as the Pediatric Medical Home Program, Feinberg added.
Last year’s health care expenditures in the United States totaled more than $3 trillion, said Patrick Dowling, chairman of the UCLA Department of Family Medicine.
The most important part of that total is that only a very small percentage of patients account for about half of those expenditures, Dowling added.
Hospitals are now trying to target these shortcomings to reduce the soaring costs of health care, Stobo said.
Feinberg said ideas for cost reduction include penalties on hospitals for high readmission rates and rewards from insurance companies for certain standards, such as having an electronic record system for patients.
Linda Demer, a cardiologist at the Ronald Reagan UCLA Medical Center, said one of the most visible aspects of the bill has been its psychological impact.
“More than anything, I’ve seen optimism,” Demer said.