Texas Hospital Association Leadership Conference February 17, 2010

1. Texas Hospital Association Leadership Conference February 17, 2010

2. Texas Partnerships • % of Texas hospitals are AHA members • PAC Leadership – 102% of goal! • AHA Governance • Advocacy Agenda

3. “Health For Life”

4. AHAMember Reaction

5. AHA Members Support Advocacy Efforts

6. Senator-elect Scott Brown… “Changed the Game” • Reach a deal and passbefore Brown is sworn in. • Try to attract GOP support in the Senate. • Restart using the reconciliation process. • Complete restart…or stop

7. Option - 1 • House passes Senate bill with nochanges…with promise to fix later (using reconciliation process) • House must accept many provisions: • Tax on Cadillac plans • Less expansive coverage provisions • State based exchanges • IPAB • No Rx doughnut hole closure • No ARRA FMAP extension • Immigration restrictions • No Stupak amendment • Not popular with the Democratic caucus rank and file

8. Option – 2 • Chop up reform…and consider individual elements in separate bills • Insurance reform…consumer protections • Repealing antitrust exemption for insurers • Financial incentives to states to expand Medicaid • Tax incentives for small business

9. Options – 3 and 4 • Restart with scaled-down package • No health care reform…move on to other key issues (jobs)

10. President’s Budget • Less specific than previous budgets • Assumes health care reform • No specific Medicare policy changes to achieve savings • FMAP relief in 2011 • Increase in fraud and abuse funding • COBRA • Domestic discretionary freeze • Bipartisan fiscal commission • Assumes physician fix

11. Medicare physician payments Expires February 28 • Included in debt limit extension bill • Statutory pay-go with exemptions: • Medicare physician fix (5 years) • Estate tax (2 year) • AMT patch (2 year)

12. Now What? • White House and Congressional leadership need to take the next steps. • The issues we have been working to address are not going to go away…and we would hope there could be a bipartisan path to addressing them. • Our Health For Life principles will guide us: • Expanding coverage • Increasing affordability • Improving patient safety and quality • We’ll continue to work with Congress andthe Administration to fix what’s broken…and educate them on what’s worth protecting.

13. Proven Best Practices for Patients www.HPOE.org

14. Health Reform – Health for Life AHA Task Force on Care Coordination Task Force on Payment Reform HFL Workgroup on Clinical Integration

15. Proposed Reform Policies and Stated Objectives

16. Health For Life – Reform Bills 59! • Health For Life’s five pillars are • our guide for long-term change. • All five pillars… • Coverage for all Paid for by All, • Focus on Wellness • Most Efficient, Affordable Care; • Highest Quality Care • Best Information • …were reflected in the reform bills and will guide us no matter what happens in Congress. 41!

17. Questions?