St. Louis - The green light for the Affordable Care Act will
accelerate changes to the local health care system that have already
begun ahead of a coming wave of newly insured patients and
incentives to keep them healthy.
The law, largely affirmed by the U.S. Supreme Court on Thursday,
means millions of Americans who don't have insurance will become
covered by 2014.
It will also mean a stronger emphasis on preventive medical
services. For example, hospitals will be able to earn incentives for
improving patients' health instead of getting reimbursed by insurers
only for procedures they perform.
To prepare for the changes, St. Louis-area hospitals have been
adding outpatient clinics or buying up independent doctors' groups
to better collaborate on patient care. The goal: to encourage better
treatment of patients early on and reduce costly emergency room
visits and admissions.
Most recently, St. Anthony's Medical Center in south St. Louis
County absorbed Southwest Medical Center, a 15-doctor medical office
on Watson Road. The Mercy hospital system is expected to announce
today a merger with Patients First doctors' group in Washington, Mo.
Such moves are expected to help primary care doctors better
coordinate with specialists.
"Hospitals and health systems will continue to integrate, which
on balance should improve health care for all of us," said Mark
Goran, a local health care attorney. "It should also reduce the cost
because coordination should keep people out of the hospitals."
Steven Lipstein, president of BJC HealthCare, the region's
largest hospital operator, said another benefit for hospitals will
be a drop in uninsured patients who now use an emergency room for
"A great many of those patients, now they'll have (insurance) and
hopefully will come to us sooner, when they're faced with either
medical conditions or symptoms, so that we can help them avoid
hospitalization," he said.
Local hospitals also are expected to see an impact on their
bottom lines. Their debts could decrease, as fewer uninsured
patients means fewer uncollectable bills.
"Patients entering the nation's hospitals will be much more
likely to be carrying an insurance card," said William Smith,
director of the health care practice at NSI, a Washington consulting
Like other hospital systems, SSM Health Care, which operates
seven hospitals in the region, had not waited for the Supreme
Court's ruling to prepare. …