Dan Neufelder, CEO and president of the Affinity Health System, recently took on the expanded role of senior vice president of hospital operations for Ministry Health Care and now also oversees 12 other Ministry hospitals. Neufelder has worked in health care for 33 years, first as a public accountant and consultant. He sat down with Associate Editor Nikki Kallio to talk about the U.S. Supreme Court ruling on the Affordable Care Act and how it relates to changes being made within the Affinity Health System.
On June 28 the U.S. Supreme Court voted to uphold the Affordable Care Act. The surprising part about it is that in the law there’s a penalty if individuals choose not to buy insurance, and that penalty was considered a tax. In health care there were people that were sure it was going to be struck down, and people equally as sure that it was going to be upheld, but I don’t know if anyone anticipated that it would be upheld based upon that the penalty is a tax.
The second very significant thing about the Supreme Court’s findings was related to the Medicaid expansion – that the federal government could not put the entire program funding at risk for an implementation of just part of it. There were two big lynchpins of health care reform. One was this individual mandate, so everyone has access to insurance regardless of pre-existing medical conditions. This is very significant – and for many people, this is a watershed event. Out of the 50 million people that currently do not have health insurance, it was estimated that over 30 million of them were expected to be able to access health care insurance through the expansion of Medicaid programs. So now that the states are not required to expand Medicaid, that brings a lot of uncertainty into how many people will actually receive their health insurance through Medicaid. It actually could leave us as a nation with a substantial number of people that are still uninsured.
We believe true health care reform does not happen in Washington D.C.; it doesn’t happen in Madison. Real health care reform happens between physicians, caregivers and their patients. Over two years ago, we started on an initiative that’s called the Affinity Medical Home Model. It’s an approach towards primary care that’s patient-centered, physician-led and team-based, and it tries to provide the absolute best level of primary care to each and every patient, and thus that home notion – that we’re trying to create a “home” for every patient.
We’re also investing heavily in electronic medical records so everyone involved with a patient has access to the latest patient information possible, as well as greater portability for patients of that information wherever they go.
We’ve been working in collaboration with ThedaCare and Children’s Hospital Wisconsin over the course of the last three years to try to improve mental health services to children and adolescents and improve access to those services. The three partners have come together to form Catalpa Health. We have plans in the fall to begin seeing patients.
What does health care reform mean to the average person on the street? It means you will always have access to affordable health insurance regardless of your medical condition and regardless of your age, and that’s very comforting.
For businesses, it’s a little bit more complicated. Businesses with over 50 workers will be required to provide health insurance for their employees, or pay a penalty of $2,000 per employee. If you’re under 50 employees, you are not required to provide health insurance. If you’re under 25 employees, you actually are eligible for a tax credit if you provide health insurance, so from that standpoint, that’s something that I think every business will be working through. For large employers, on the short term, it probably doesn’t mean a lot of changes, but in the long run there is a special tax that’s on “Cadillac” plans, or high-cost employer-sponsored plans. Today for almost all employers, insurance is underneath this Cadillac level. It’ll be interesting to see how that works moving forward.