Leaders with the Houston Methodist Willowbrook Hospital met with U.S. Rep. Kevin Brady, R-The Woodlands, April 10 to discuss advocacy issues related to health care in the region. Issues discussed at the visit included research funding, the ongoing physician shortage and Medicare reform.
"I've had the opportunity to watch the growth of Houston Methodist in Willowbrook, and I want to make sure my health care team knows exactly the challenges [they are] facing so we can be helpful," Brady said. "Part of it is how we can help [them] meet [their] goals, and part of it is to make sure [they] will be a resource to me as we go about improving health care."
Brady, chairman of the U.S. House of Representatives Ways and Means health subcommittee, sponsored House Resolution 2, which repeals and replaces the sustainable growth rate formula for Medicare. The plan, which deals with how doctors get paid for treating patients who depend on Medicare, was passed by the House March 26 and the Senate April 14, both with bipartisan support.
"The problem [with Medicare reimbursements] surfaced about 15 years ago," Brady said. "It started out irritating and frustrating. Over time, physicians started rethinking their relationship with Medicare, with fewer doctors seeing seniors. If there is any population group that needs to see a doctor who knows and is familiar with them, it's our seniors."
Brady provided an overview of the new SGR, which he said goes beyond reimbursing doctors with fees for service and toward reimbursements based on quality of care.
"Reimbursements are incentive-based, which encourages physicians to focus on innovation, quality and patient outcomes," Brady said. "It also streamlines some of the complexities and regulations our physicians and hospitals have to deal with. We're looking to subtract some of the red tape over the next 10 years."
Methodist officials, including government affairs representative Veronica Karam, expressed support for the reform. Keith Barber, Willowbrook's CFO and vice president, noted Medicare payments in 2014 came in at about $74 million, while costs were roughly $90 million, creating a total loss of around $16 million. The portion of the population that uses Medicare is expected to grow faster than people using private insurance over the next five years, he said.
"The Medicare and Medicaid population is the most difficult population to serve because a lot of patients have psychological and sociological issues," he said. "If anything, this is a conservative estimate from a cost perspective because we provide so many resources to this population."
Karam spoke about some of Methodist's other advocacy issues, including finding solutions to address the ongoing physician and nurse shortage. As a teaching hospital, Methodist has 35 graduate medical education programs with 251 residents enrolled in 2015
Although Methodist is producing a number of promising doctors through its education programs, Karam said federal limits on the number of slots available in matching residency programs have created a bottleneck.
"The [Affordable Care Act] reallocated the slots throughout the U.S. in 2010, and Texas lost 60 slots, which doesn't make sense considering our growing population," she said. "Because of the cap on residency slots, a lot of [doctors] have to wait. We would like there to be more funding for [graduate medical education], but given the budgetary constraints, a reallocation of the slots to where the need is would be another way to go about resolving this issue."
Karam also discussed Methodist's behavioral health program, which is focused on improving continued care for patients who are considered high-risk for return visits. Patients who agree to participate in the project are contacted by hospital officials one week after being released for a follow-up on how they are doing.
"So often these patients fall into cracks," Karam said. "They're not able to transition. We ask them how they're feeling and how we can help. We ask what their challenges are, whether they're struggling with finding rides, or paying for medication. It's really innovative and changing the way we interact with patients."
Debbie Sukin, CEO of the upcoming Methodist hospital in The Woodlands, reiterated the appreciation hospital officials have for Brady's efforts to stay connected.
"Every time [Brady] comes back to town, he asks to sit down with the new physicians and visit to find out what we need help with," she said. "It's great to have someone like that who can go back to Congress and communicate what our community is thinking related to key issues."