Scott reacts to SCOTUS ruling

Published 1:42 am Sunday, July 1, 2012

The fact that the Supreme Court, in a 5-4 decision, upheld the majority of President Barack Obama’s Affordable Care Act on Thursday will improve access to health care for many people, but it will not come without challenges for those who will be tasked with providing that care, LSU Bogalusa Medical Center CEO Kurt M. Scott said.

During an interview Thursday, Scott said he is pleased that the Supreme Court has now taken action on the issue.

“It removes some uncertainty as to where health care is going and allows for the continued transformation of health care in the United States,” he said.

The LSU System, like the majority of health care providers, is anticipating that the result of the ruling will be “an increased demand for services, as more people have access to care.”

According to some estimates, between 300,000 and 400,000 people in the state who were previously uninsured could now be able to make the shift to having Medicaid coverage, Scott said. Though the requirement that all states move forward with the Medicaid expansion was removed by the Supreme Court, Louisiana might still decide to participate in the expansion, he said.

“I think that’s probably what’s going to happen in Louisiana: More folks will be eligible to come into Medicaid and these patients will have greater access to preventative care and comprehensive care, whereby in the past they may have relied on the disproportionate share program for emergency care,” he said.

While the demand is expected to increase, the vast majority of Louisiana parishes and a number of other states are health professional shortage areas, meaning there are “just not enough health providers to go around.”

Thus, the role that the LSU System plays in “training the majority of all the health care providers in the state will be even more important,” Scott said. LSUBMC, he said, is focused on training family medicine residents, who provide primary care, through its residency program.

“They’re going to be among those in the greatest demand under the new healthcare mode of delivery with the Affordable Care Act,” he said.

The fact that more members of the public will have access to care “ultimately will be good for our society,” Scott said.

“The problem, I think, that we’re going to be dealing with is there will be more people increasing the demand at a time when there are shortages of doctors, and then, how do you pay for it is the issue,” he said.

If Medicaid coverage is expanded, Scott said, more resources will be required to pay for the services. Additionally, since not all doctors accept Medicaid, those patients currently have limited access to specialists and other physicians, he said.

“These new people who have access to care will have to seek care where they can; and that’s part of our mission and we’ll be here for them,” he said.

The implementation of the new health care law will have a direct impact on LSUBMC, Scott said.

“We anticipate increased demand for care, and at the same time we have a dual role here because we also, as part of the LSU System, are responsible for training new doctors and nurses,” he said.

The model of care already in place at LSUBMC should help ease the transition to the Affordable Care Act, Scott said. The medical center has an integrated delivery system, where the doctors and staff are “all employed by the same provider, and they work together to provide coordinated care to the patients,” he said.

“I think that the emphasis on medical homes, where patients can seek coordinated care from one provider, and that provider can be responsible for coordinating their care among specialists and making sure that their medical records are available to be accessible by other specialists and that the care is provided in a comprehensive, coordinated way is a model that is specifically called for in the Affordable Care Act,” he said.

Three years ago, the National Committee for Quality Assurance certified all of LSUBMC’s clinics as medical homes, Scott said.

“Our clinics provide that type of care in a coordinated fashion, which is a requirement of the medical home concept, so we’re ahead of the curve there,” he said. “Also, the LSU System is in the implementation phases of putting in an electronic health record, which is also a requirement of the Affordable Care Act.”

The electronic health record at LSUBMC is scheduled to be brought online next year, and that will make patient records more readily accessible and aid in the process of referral to a specialist, Scott said.

The adoption of a coordinated care model, or medical home model, and the implementation of a system to provide electronic access to health records “are all items that are specifically spelled out in the Affordable Care Act,” Scott said.

“We’ve already made progress in each one of those areas,” he said.

Moving forward with the new health care act, systems will have to focus on cost efficiency, by providing care that is both high quality and low cost, Scott said.

“LSU is a model in that regard,” he said. “All the state hospitals provide a high level of care in comparison to industry standards. The hospitals all operate at the low end of cost in comparison to industry standards, and I think that’s a combination which will be important and which leads to efficiency and good quality.”

Keeping all those factors in mind as the demand for services increases will be important, Scott said.

“I think we’re well positioned here in Bogalusa,” he said. “Our focus is on primary care. That’s the focus of what all patients need, and we’re training primary care doctors here and we’re delivering coordinated care in our medical home clinics. And we’re using the latest technology to do it efficiently.”

Riverside Medical Center CEO Calvin Green could not be reached for comment about the ruling.