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Health Reform

A few words could affect millions of people

Benjamin Wills of Atlanta is among the more than 400,000 Georgians receiving a subsidy to afford health insurance in the Affordable Care Act exchange.

With the subsidy, Wills is paying a monthly premium of $370 for family medical and dental coverage through the exchange.


Benjamin Wills

If he loses the subsidy, Wills said Wednesday, he could be forced to drop his family’s dental coverage, and perhaps re-enroll his daughter in the government PeachCare program.

“The way [the ACA] is now is working for our family,’’ said Wills, who recently left a job with benefits to start a private Christian school in Atlanta.

The fate of the insurance subsidies – and the future of the Affordable Care Act in general – were on the line as the U.S. Supreme Court heard arguments Wednesday on the legality of the credits in the exchanges in Georgia and 36 other states.

This case, King v. Burwell, is not officially a challenge to the ACA. Instead, the plaintiffs in the case say the law is not being followed. They argue that the subsidies, which help people afford coverage, are not permitted by the health law in the 37 states that have federally operated insurance exchanges.

After more than an hour of arguments in the case Wednesday, the justices appeared divided over the subsidies issue. full story

Rural health panel offers plan to cut ER use

A special state panel created by Gov. Nathan Deal has proposed a pilot program that would use telemedicine and other techniques to bolster rural health care in Georgia.

The Rural Hospital Stabilization Committee report, released Monday, supports a “hub and spoke’’ model to relieve the burden on rural hospital emergency rooms. It would use telemedicine-equipped ambulances to facilitate remote diagnoses of patients in rural areas.

clipboardTelemedicine basically is the transmission of video and digital vital signs of a patient to a physician at another location who can evaluate that information for a diagnosis. Georgia has been a pioneer in this field.

The four pilot sites would be based in hospitals that serve different rural regions of the state: Union General in Blairsville, Appling HealthCare in Baxley, Crisp Regional in Cordele and Emanuel Medical Center in Swainsboro.

The report of the Rural Hospital Stabilization committee makes no mention of the possibility of Medicaid expansion in the state, which is opposed by Deal and the Republican legislative leadership due to cost concerns. full story

Exchange enrollment soars past half a million

Powered by a late surge, Georgia’s enrollment in the 2015 health insurance exchange easily surpassed the half-million mark.

Federal officials said Wednesday that 536,929 Georgians selected a plan or were automatically re-enrolled in the state exchange. The Affordable Care Act provides for exchanges in all 50 states, and this is their second year of operation.

Sylvia Burwell

Sylvia Burwell

Open enrollment ended Sunday. The figures show that Georgia enrollment accelerated in the final two weeks, with more than 60,000 signing up. As of Feb. 6, 468,464 had enrolled in coverage in Georgia.

This year’s enrollment number far outpaces last year’s Georgia exchange total of 316,543, and exceeded many projections for the state.

Nationwide, about 11.4 million Americans selected exchange, or marketplace, plans or were automatically re-enrolled, the U.S. Department of Health and Human Services announced. That was 10 percent more than expected, HHS said Wednesday. full story

Merger would create a giant in Atlanta health care

It’s a long way from being a done deal, but if it happens it will shake up metro Atlanta health care.

Emory University and WellStar Health System announced last week that they are discussing a merger of their medical assets, a fusion that would face regulatory and logistical challenges. Completion of a deal is at least a year away.

Emory University Hospital Midtown

Emory University Hospital Midtown

Yet the news of even a possible marriage between nonprofit heavyweights Emory Healthcare and WellStar sent a tremor through the metro Atlanta health care industry.

The proposed union would be the biggest example of hospital consolidation so far in Georgia, and it could trigger other combinations.

Standalone metro hospitals such as Gwinnett Medical Center and DeKalb Medical may be forced to consider aligning with other entities, said David Smith of Kearny Street Consulting. full story

Emory, WellStar discuss a blockbuster merger

In the turbulent business of health care, bigger is often better.

Nowhere is that more evident than in the stunning announcement Monday that Emory University and WellStar Health System are talking about merging their medical assets in metro Atlanta.

If a deal is consummated, the resulting nonprofit health system would clearly be Georgia’s biggest and would comprise one of the largest such organizations in the nation.

WellStar Kennestone Hospital

WellStar Kennestone Hospital

The talks come at a time of revolutionary changes in health care, many of which were ignited by the Affordable Care Act.

That upheaval is having a profound effect in the Georgia hospital industry. Recently, GHN reported that the Texas-based chain Tenet Health is seeking a partner or buyer for its Georgia hospitals.

And Piedmont Healthcare, based in Atlanta, has begun talking about a partnership with St. Francis Hospital in Columbus, which is reeling from a $30 million accounting inaccuracy.

A merger, if completed, would combine Emory’s academic health system with WellStar’s expertise in running community hospitals.

“We want to end up with the best of community health care and the best of academic health care,’’ Emory University President James Wagner said Monday. “We hope to be a model for the Southeast and the rest of the country.”

It would also create a system with geographic reach across Atlanta and into the city’s northwest suburbs, where WellStar dominates the market. full story

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