Stakeholders in Health Reform
When talking about healthcare reform, one must always think about the stakeholders. Stakeholders are “people and organizations that have a stake (interest) in what a healthcare organization does and that could affect the healthcare organization” (Olden, 2011). There are many different stakeholders in our case study but we will focus on the main ones.
In Massachusetts, the Massachusetts Health Care Reform Act had a considerable impact on hospitals and the health care system. Most community health centers were benefiting from coverage expansions and safety net hospitals were struggling financially due to the fact that the state put more funding towards insurance subsidies to expand coverage. Academic medical centers (AMC) were able to command higher prices and attract more patients from community hospitals due to the fact that policy makers kept putting off making decisions about slowing the growth of healthcare spending. AMCs “received the highest payment levels and were able to negotiate the largest percentage increases, which increased the spending trends and widened the disparities between have and have-not providers in the market.” The more prestigious, big name hospitals had more power and thus could exercise more leverage. AMCs also expanded to the suburbs, which posed a considerable amount of threat to community hospitals by “raising the rates paid for services delivered in community settings and by increasing the number of referrals to downtown AMCs, which command the highest rates.” Physician/ providers who owned free-standing, ambulatory centers had been approaching hospitals with offers to sell their facilities due to the fact that they were becoming less profitable due to “updated fee schedule and more aggressive health plan utilization management.” Physicians were also aligning themselves with hospitals and other larger practices. Small practices risked losing a large share of their patient panels if they dropped out of health plan networks. The impact
In Massachusetts, the Massachusetts Health Care Reform Act had a considerable impact on hospitals and the health care system. Most community health centers were benefiting from coverage expansions and safety net hospitals were struggling financially due to the fact that the state put more funding towards insurance subsidies to expand coverage. Academic medical centers (AMC) were able to command higher prices and attract more patients from community hospitals due to the fact that policy makers kept putting off making decisions about slowing the growth of healthcare spending. AMCs “received the highest payment levels and were able to negotiate the largest percentage increases, which increased the spending trends and widened the disparities between have and have-not providers in the market.” The more prestigious, big name hospitals had more power and thus could exercise more leverage. AMCs also expanded to the suburbs, which posed a considerable amount of threat to community hospitals by “raising the rates paid for services delivered in community settings and by increasing the number of referrals to downtown AMCs, which command the highest rates.” Physician/ providers who owned free-standing, ambulatory centers had been approaching hospitals with offers to sell their facilities due to the fact that they were becoming less profitable due to “updated fee schedule and more aggressive health plan utilization management.” Physicians were also aligning themselves with hospitals and other larger practices. Small practices risked losing a large share of their patient panels if they dropped out of health plan networks. The impact
Cited: James, L. H., & Rebecca, F. A. (2007). The massachusetts health care reform act: What employers need to know. Employee Benefit Plan Review, 61(12), 17-19. Retrieved from http://search.proquest.com/docview/216889767?accountid=10559.