MAHA Annual Meeting June 10, 2015 Dave Finkbeiner Senior Vice President, Advocacy Stacy Dowdy Manager, Health PAC & Grassroots Advocacy 1
Objectives for Today Overview of the Health Care/Political Climate Identify current major legislative issues that impact Hospitals Identify ways to become involved in advocacy 2
General Observations on Healthcare Uncertainty With or without Obama Care healthcare was going to change; in what ways and how fast? The Fatigue Factor Lawmakers are tired of heated healthcare debates, so while much talk of repeal or dramatic law changes there is very little interest Moore s Law Technology capabilities double every 18 months. Medical technology is now mobile and miniature. Doctor/Patient relationship changing, no longer has to be face to face 3
General Observations on Healthcare Wild Cards Low probability of occurring but huge impact. Ex: ACA, Supreme Court ruling that said States can choose to expand Medicaid. Initially 27 states said no King v. Burwell US Supreme Court (subsidies for federal exchanges) decision by end of June Rebuilding the house while it s still burning Today paid on volume, tomorrow paid on value (high quality at low price) 4
Facts About MI Hospitals Healthcare is Michigan s leading source of private-sector jobs 223,000 hospital jobs 580,000 direct healthcare jobs Healthcare employees generate $33 billion a year in wages, salaries and benefits Michigan hospitals are highly efficient Costs rank 9.7 percent below the national average and translate into annual savings to employers of at least $500 million Michigan hospital costs ranked 7.1 percent below other Great Lakes states (Indiana, Illinois, Ohio, Pennsylvania and Wisconsin)
More Integrated MICHIGAN HOSPITALS 1980: 236 Hospitals; 49,369 total beds Nearly all independent 2014: 134 Hospitals; 24,617 total beds 20 systems = over 100 hospitals 8 out-of-state systems (4 for-profit) 36 Critical Access Hospitals (1,300 in U.S.) Estimated 65% of practicing Michigan physicians are either employed or near-employed by hospitals 6
Non-profit or For-profit Healthcare? Non-profit Community owned Value driven charity, justice, healthcare is basic need Reinvest in community High quality Unprofitable patients Access to care, under utilized facilities? Difficult to attract funding Serve the community For-profit Investor-owned Free enterprise-efficient, competitive Profit to share holders High quality Fair share Greatest benefits at least cost Quicker access to capital Pay taxes 7
More Transparent Scrutiny of cost, quality, and service will intensify Variation in clinical practice patterns and pricing 8
2014 Election
Political Climate Elephants in Charge Endangered Species 10
Branches of Federal Government Executive President Barack Obama (D) Legislative U.S. Senate 54 Republicans/44 Democrats 2 independents U.S. House 244 Republicans/188 Democrats 3 independents Judicial Supreme Court (not elected) 5-4 Republican Majority 11
Michigan Loses Seniority U.S. Senate Sen. Carl Levin (35 yrs) U.S. House of Representatives Rep. John Dingell (59 yrs) Rep. Dave Camp (23 yrs) Rep. Mike Rogers (13 yrs) Rep. Gary Peters (5 yrs) Rep. Kerry Bentivolio (2 yrs) Total experience + seniority lost = 137 years 12
Branches of State Government Executive Governor Rick Snyder (Republican) Legislative State Senate: 27-11 Republican Majority State House: 63-47 Republican Majority Judicial State Supreme Court: 5-2 Republican Majority 13
Legislative Breakdown & Term Limits Term limits have resulted in an influx of lawmakers at the beginning of their career and beginning retirement. 44 new state lawmakers (43 House/1 Senate) 21 legislators under the age of 35* 12 Republicans, 9 Democrats 13 of which are incoming freshman Age 25 is youngest (V. Guerra) 9 legislators over 65 *Record in modern Michigan political history; MIRS 11/10/14
Legislative Breakdown & Term Limits Average age is still 48.7 27 women legislators (18%) 2 physicians, 2 paramedics, 2 social workers, 1 chiropractor, 1 nurse 1 former government affairs officer for a health system, 1 former legislative liaison for MDCH and 1 hospital board member
The New Quadrant leaders House Senate Speaker Kevin Cotter Majority Leader Arlan Meekhof Minority Leader Tim Greimel Minority Leader Jim Ananich 16
Appropriations Committee Chairs House Senate Al Pscholka Dave Hildenbrand MDCH Subcmte Chair Robert VerHeulen MDCH Subcmte Chair Jim Marleau 17
Health Policy Committee Chairs House Senate Mike Callton Mike Shirkey 18
Health Providers State House 2 New Physicians Rep. John Bizon, MD 62 nd District Rep. Ned Canfield, DO 84th District 19
State Advocacy Proactive CRNA Opt-out (SB 320) Fiscal Year 2016 Dept. of Community Health Budget On Watch Nursing Scope of Practice (SB 68) CON Reform/Repeal Defense Auto no-fault reform (SB 248-249, SB 288) Provider rates set at 150 percent of Medicare (negative impact to Michigan hospitals $1.2b annually) Creation of a new clearinghouse for catastrophic claims D (Detroit) Auto Insurance 20
Developing the MHA s Legislative Priorities HALO (hospital affiliated legislative officers) MHA Membership Regional Policy Forums/Regional Councils Committees, Councils, Task Forces, MONE Legislative Policy Panel MHA Board of Trustees MHA Executive Committee 21
Key Elements to MHA Advocacy Success MHA and members advocating with unified voice Member participation in targeted advocacy days: Healthcare Advocacy Day, Small/Rural Advocacy Day, GME Advocacy Days Access to and support from legislative leaders and the Governor Maintaining strong Health PAC contributions to assist with relationship development and access to legislative leaders
Why Advocate? ad vo cate v. to speak or write in favor of; support or urge by argument; recommend publicly: As a member of one of the state s largest organizations representing the interests of Michigan hospitals, it is imperative that you advocate and BE an advocate! You have the power to make hospital and health care better! 23
To whom does one advocate? Village/City/Township/County Government State Government Michigan House Michigan Senate Governor Federal Government Congress President 24
Advocacy 101 What To Do Stay informed Join or organize a group around specific issue(s) Meet your lawmakers and key staffers Send a letter, email or voice mail Share expert knowledge - be brief and constructive, prioritize concerns, use your own words Recognize the role that money plays in politics Write letter of appreciation 25
How to contact your legislator WRITE CALL VISIT 26
Who is my lawmaker? http://www.mha.org/advocacy/action_center.htm Type in current address and click search icon
Who is my lawmaker? State lawmaker list Click on lawmaker name for contact information
What issues are in play? http://www.mha.org/advocacy/action_center.htm Click on arrow icon
Click on underlined title to view advocacy campaigns and contact your lawmaker What issues are in play?
What issues are in play? Steps to send lawmaker a letter with MHA talking points already included: 1. Customize letter (if desired) 2. Sign letter 3. Fill out email address and zip code* 4. Click continue 1. *Zip code will be used to determine your lawmaker as shown on previous slides 2. 3. 4.
www.mha.org MHA Talking Points
MHA Talking Points http://www.mha.org/newsroom/talkingpoints.htm
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