Election Impact on South Florida Health Care Sectors

Carlos A. Migoya, President and CEO, Jackson Health System; Steven Altschuler, Sr., M.D., Senior Vice President for Health Affairs, University of Miami, and CEO, UHealth - the University of Miami Health System; and   Orlando L. Alvarez, Jr., Chief Strategy Officer, Cleveland Clinic Florida
Carlos A. Migoya, President and CEO, Jackson Health System; Steven Altschuler, Sr., M.D., Senior Vice President for Health Affairs, University of Miami, and CEO, UHealth - the University of Miami Health System; and Orlando L. Alvarez, Jr., Chief Strategy Officer, Cleveland Clinic Florida
Carlos A. Migoya, President and CEO, Jackson Health System; Steven Altschuler, Sr., M.D., Senior Vice President for Health Affairs, University of Miami, and CEO, UHealth - the University of Miami Health System; and   Orlando L. Alvarez, Jr., Chief Strategy Officer, Cleveland Clinic Florida
Carlos A. Migoya, President and CEO, Jackson Health System; Steven Altschuler, Sr., M.D., Senior Vice President for Health Affairs, University of Miami, and CEO, UHealth - the University of Miami Health System; and Orlando L. Alvarez, Jr., Chief Strategy Officer, Cleveland Clinic Florida

Changing federal and state health care reimbursement programs could have a major financial impact on South Florida’s health systems, according to Steven Altschuler, Sr., M.D., SVP for Health Affairs, University of Miami, and CEO, UHealth - the University of Miami Health System.

“We all have to make decisions for our institutions in a very uncertain health care environment,” Altschuler said. “But we know that the ability to compete on cost will really be critical for our systems.”

Altschuler moderated a panel discussion on "Election Impact on South Florida Health Care Sectors" with Carlos A. Migoya, president and CEO, Jackson Health System, one of the nation’s three largest public health systems; Orlando L. Alvarez, Jr., chief strategy officer, Cleveland Clinic Florida in Weston; and N. Narendra Kini, M.D., CEO, Miami Children's Health System in Miami.

Migoya kicked off the discussion by saying that health care providers were the losers when Florida opted not to expand Medicaid coverage after the passage of the Affordable Care Act (ACA). “That had a $160 million negative impact on Jackson, but we have been able to hold our own,” he said.  “The number one way to reduce overall costs is through patient population management. That will create opportunities for Jackson to share risks and revenue, while delivering coordinated care.”

While the impact of replacing the ACA might not be felt at the regional level for two or three years, Migoya said he is hopeful that Congress would eliminate the act’s “disproportionate share” provisions, which could result in Florida receiving more funds to cover low-income residents.

Noting that President Obama focused on expanding coverage, Alvarez said Florida wound up with 1.7 million people covered under the ACA, including 500,000 in Miami-Dade. “Now the Trump administration is looking at cutting costs,” he said. “At Cleveland Clinic Florida, we are also focusing on lowering costs, while improving care. We’re in a steady state on new initiatives, waiting to see what happens in Washington.”

At Miami Children’s Hospital System, about 67 percent of pediatric patients are covered by Medicaid, Kini said. “Any alteration to the reimbursement program, or coverage for pre-existing conditions could really impact our patients, particularly the medically fragile kids. We are also holding steady, paying attention to costs and watching the policy makers.”

 

Risk-sharing and capital investments

Risk-sharing financial arrangements will continue to grow in South Florida said the health care executives.  “Providers will need to embrace risk and use technology to understand their costs,” Alvarez said. “Instead of avoiding risk, we need to find ways to win at that game.”

Kini agreed and pointed to the importance of data sharing to learn more about patient groups. “Population health is the way to go, as we look for ways to standardize and improve primary care environments.”

Noting that all three hospital systems – as well as UHealth – have major expansions underway, Altschuler asked the panelists to discuss their business strategies.  For Jackson, capital investments are aimed at making the public system the “brand of choice” for patients, while increasing accessibility to care and lowering costs, Migoya said.

Cleveland Clinic Florida is undergoing a clinical transformation, said Alvarez.  “We are expanding our campus in Weston and our facility in Coral Springs, using our current assets to provide greater access,” he said.

Looking at the future of pediatric medicine, Kini said most children who need services will be treated on an outpatient basis. “We are refurbishing our emergency department, intensive care unit and operating rooms on our campus, because that will continue to be a long term need.” he said “Other services will be migrating to outpatient settings, and we are using our virtual health platform to reach families at home. We also believe that standardization of processes that show safe and effective pediatric care are what will help to bend the cost curve.”

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