Talking Straight about the ACA

By Gena Akers, GetHealthySLV.org

While Colorado’s health care leadership is strong and implementation of many Patient Protection and Affordable Care Act (ACA) provisions are smoothly underway, confusion still lingers on what real impact the law will have on decreasing health care costs and improving health care delivery. As part of the Talk Straight with Adams State series, Adams State University’s Community Partnerships hosted a forum, “Affordable Care Act: What You Need to Know,” to dispel confusion and misinformation about the law.

The forum’s panel included Ned Calonge, MD, President and CEO of The Colorado Trust, as well as Tom Deegan, a registered nurse and author of Healthcare: A View from the Trenches; Reginaldo Garcia, PhD, Program Director, Rocky Mountain Prevention Research Center; Russ Johnson, CEO of the San Luis Valley Regional Medical Center; Gigi Darricades, CEO of Valley-Wide Health Systems (VWHS); Marguerite Salazar, regional director for the U.S. Dept. of Health and Human Services (HHS); and Armando Valdez, Adams State University professor of health care administration.

During her keynote address, Salazar used her sister-in-law and 35-year-old nephew, Joseph, as examples of why health care needs to change. While pregnant with Joseph, Salazar’s sister-in-law received her prenatal care from the emergency room. “Even though she had health insurance, at the time there were not enough providers in the Valley and she didn’t know where else to turn.” explained Salazar.

As the former CEO of VWHS, Salazar added that every time VWHS opened up a new clinic, it showed her where the system was failing. “Our patients didn’t want to be ‘freeloaders.’ They didn’t want to show up and not pay their bills.”

Fortunately, there is good news. Salazar and the panelists explained that, thanks to the ACA, millions of people who were previously uninsured now have coverage and greater access to preventive services.

Regarding access to new health insurance through Colorado’s insurance marketplace, Calonge hopes the marketplace will provide people with an understanding that they really do have choices. “Most of us spend more time thinking about what we want in our Starbucks coffee than we do in deciding what should be included in our insurance plan.”

In addition to explaining the impact of the ACA on the individual, panelists also shed light on what changes patients could expect to see in health care organizations. “The ACA makes our ability to attract and retain physicians stronger,” said Jonson. “Before the ACA, we saw uninsured patients but didn’t get paid for it. Now, we still do, but get reimbursed in a different way. That makes us more competitive and strengthens our ability to provide better care.” Calonge added that he sees the ACA as a significant benefit to today’s providers. “There is work here for all of us and there is the payment reform to support us.”

In the end, the audience’s questions centered on whether or not the law would result in a healthier population. As Garcia asked, “Can we engineer change?” Panelists agreed that while that’s not possible, the ACA and other statewide initiatives currently underway can make it easier for individuals to adopt healthy habits. “The ACA won’t do this,” said Calonge. “But Colorado communities can. For true success, this must be owned by the community.”

Calonge, who was on the taskforce which generated the list of preventive services that will be covered by all insurance offered through the marketplace, explained that the ACA’s focus on prevention is about more than cutting costs. “Prevention does save money, but we have to rethink it. (Preventive services) deliver changes in our behavior and in our communities. We develop safe, walkable communities, healthy cafeterias, no smoking. When you keep your weight down, you will have less chronic diseases. That is a different kind of savings.”

To read more about Alamosa’s recent forum, visit GetHealthySLV.org.

(Clockwise starting at top left) Marguerite Salazar, Regional Director, U.S. Dept. of Health and Human Services; Russ Johnson, CEO, SLV Regional Medical Center; Armando Valdez, Professor, Adams State University; Gigi Darricades, CEO, Valley-Wide Health Systems; Ned Calonge, MD, The Colorado Trust; Reginaldo Garcia, PhD, Program Director, Rocky Mt. Prevention Research Center; and Tom Deegan, RN and author, Healthcare: A View from the Trenches.