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Sen. Angus King: ACA Not Just About Access to Health Care
12/02/2013   Reported By: Patty B. Wight

The Obama administration is touting improvements to its trouble-plagued Web site, which has been getting lots of bad press since it officially opened in October. Independent Sen. Angus King, meanwhile, was in Maine on Monday to promote what he says are the unrecognized benefits of the Affordable Care Act. Patty Wight reports.

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The Affordable Care Act, say its advocates, is about a lot more than just increasing access to health care through new insurance options - it also aims to improve the quality of health care.

One of the ways it strives to do that is through Accountable Care Organizations - groups of health care providers who coordinate to ensure they give the best possible care to patients, without duplicating services.

MaineHealth, the state's largest health system, formed an ACO in 2010, and Sen. Angus King says the results, so far, are promising.

"What they're seeing is a decline in emergency room visits, and in readmissions to the hospital, while maintaining incredibly high quality standards," King said, at a press event in Portland.

King, who spent Monday morning meeting with MaineHealth officials, says the decrease in hospital use translates into a decline in health costs, which has the potential to have a huge impact - not just on patients, but on the nation as a whole.

"All of the federal government's future deficit problems are all about health care - it's all health care," King said. "It's not national parks, it's not Pell grants, it's not the defense department, it's not the CIA - it's health care costs." Control health costs, King says, and the deficit melts away.

Providers such as MaineHealth say they're all for reduced costs, and fewer readmissions. "That's a really good thing when you prevent someone from going back to the hospital unnecessarily," says MaineHealth's Katie Fullam Harris.

But Harris says the change has a direct impact on hospitals. "It also means, in our current payment structure, we've been paid for each admission that that patient had," she says. "So we actually lose money when we reduce readmissions."

The Affordable Care Act rewards Accountable Care Organizations like MaineHealth's that reduce costs while maintaining quality. But Harris says those reimbursements don't make up for the total cost of improving care.

"We have nurse care managers embedded in all of our primary care practices now to help patients ensure that they know what kind of medications to take, when to take them, to help them to get the different kinds of information they need to stay healthy," she says. "But that's an investment that costs money, and that's not reimbursed by the federal government."

Providers are also facing reductions in Medicare reimbursements. Harris says MaineHeath is fully committed to improving care, but new incentives need to be designed to ensure providers can still stay financially afloat.

In addition to focusing on health care providers, the Affordable Care Act is also doling out money to prevent health problems. One of the recipients of that funding in Maine is the Let's Go! program, which, for nearly 10 years, has promoted healthy eating and active living,

["We work in all 16 counties - over a thousand sites we work in," says Dr. Tory Rogers. Rogers says Let's Go! teaches kids the proper amount of fruits and vegetables to eat every day and the ideal amount of daily exercise. At the East End Community School in Portland, physical education teacher Marge Queen says its strength is in its community-wide message.

"That's the piece that's really exciting for a physical educator - that you can sit back, watch it all happen, and realize that it is growing outside your gym," Queen says - ideally, growing enough to not only create a healthier population, but to reduce health costs in the future.

Photo: Patty Wight


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