HUFFINGTON
08.19.12
PROGNOSIS UNCLEAR
Johns Hopkins has been
preparing for a new health care
system since before Barack Obama
even decided to run for president. After four years of development, Johns Hopkins opened the
doors of a new, $1 billion hospital
in April to replace venerable but
outmoded facilities that originally opened in 1889. The organization has made strides toward
streamlining its operations and
integrating the activities of its six
hospitals, 35 physician practices,
a home health care services entity
and a managed care operation that
covers 300,000 people.
Based on the expectation that
more people would be insured and
more hospital bills covered, industry trade groups endorsed the
health care reform law, which also
cuts Medicare and Medicaid funding for hospitals by $155 billion
through 2019. In addition, the law
links Medicare payments to measurable improvements in patients’
medical care, an approach private
health insurance companies also
are employing. The ongoing debate
about federal and state budgets has
Peterson concerned the government will cut back even further,
though, since Medicare and Medicaid together make up more than 45
percent of Johns Hopkins Hospital’s revenues, he said.
Johns Hopkins has taken steps
to prepare for a future in which
hospitals simply don’t bring in as
much money and are paid not for
performing the most procedures,
but for being more efficient and
delivering higher-quality services, Peterson said.
Hospitals that aren’t carrying
out plans to cut costs, and to base
clinical decisions on how well
they work, are in trouble, Skolnick
said. “If you haven’t already done
a lot of that, you’re really going to
be behind the eight ball,” she said.
“It’s a little late in the game to be
getting started.”
Whatever else happens, one
thing is certain at Johns Hopkins
and hospitals throughout the country: patients will show up every
day. Some will need high-intensity
treatments, others will have lesser
complaints but feel they have nowhere else to turn, and many of
them won’t have the means to pay.
So will health care reform ease
the process? When James Scheulen tries to envision what that
future will look like, he doesn’t
know what to expect and doesn’t
believe anyone who claims they
do. “Anybody who thinks that
they can really predict exactly
what’s going to happen is
probably making things up.”