Final Report

On August 30, 2001, health care leaders representing hospitals and managed care organizations, medical associations, doctors, nurses, educators, consumer groups, government administrators and policymakers gathered at the Northwestern Memorial Hospital to explore issues of critical importance to the health care industry. 

Congressman Phil Crane chaired the event in an effort to facilitate discussion on health care legislation pending before the 107th Congress. He welcomed attendees and speakers to Northwestern Memorial Hospital, thanked community partners for their efforts in facilitating the discussion and began the dialogue on relevant health care policy issues that are being debated at the national level. Crane also invited everyone in the audience to participate in the discussion so that he can take their suggestions back to Washington in order to help shape national discussions on health care in Congress. 

Opening Address: Gary Mecklenburg
Gary Mecklenburg, Chairman of the American Hospital Association (AHA) and President and CEO of Northwestern Memorial Hospital delivered the opening address to provide “A Perspective on Health Care Today.”  Mr. Mecklenburg delivered his assessment of the primary issues currently facing the health industry including the 2001 climate and federal agenda as well as the advocacy agenda for the AHA. He cited financial pressures including rising costs and reimbursement pressures, the importance of access to capital in light of deteriorating financial conditions of hospitals and the growing talent shortage amidst annual turnover rates of 20-30 percent and 126,000 currently registered vacancies in hospitals as primary concerns to the industry. According to Mecklenburg, the growing regulatory burden of 132,000 pages of Medicare regulations, the loss of trust in the health care system and concern about medication errors are also taxing the system. 

With regard to the federal agenda, Mecklenburg examined the impact of the new administration, the evenly split government and the shrinking surplus on issues such as a prescription drug benefit and Medicare reform. He also highlighted the AHA’s advocacy agenda that focuses on expanding the health care workforce, using the surplus to fix problems such as difficulties in acquiring and understanding payments, regulatory relief and reform, continuing the coverage and access program initiated in 1997 and assisting members with systemic change for quality and patient safety.

Session I: Addressing Industry Workforce Shortages
A panel of hospital and health care human resource representatives addressed the critical issue of workforce shortages throughout the industry. Betty Horton, Director of Accreditation and Education for the American Association of Nurse Anesthetists, expressed her concern that 40 percent of nurse anesthetists are over age 50 and will be qualified for retirement within the next few years. Additionally, she noted that though there are 23 qualified nurses for each surgical position, limited numbers of classes that are too full to accept these qualified students, leaving large numbers of vacancies unfilled. Horton urged legislators to provide funding for educational programs and fairness in reimbursement policies in order to overcome the shortage.

The aging of the workforce, a decrease in the number of entrants into health care professions and increased competition from other career options were cited by Bill Luehrs as reasons for the contracting nurse workforce. Luehrs, Senior Vice President of Human Resources at Evanston Northwestern Healthcare, also addressed the financial conditions affecting the health care industry’s workforce shortages. He cited rising personnel costs as the most threatening long-term problem for the industry, particularly considering that 75 percent of health care organizations are losing money. 

Barbara Bowman, Chief Human Resource Officer of Children’s Memorial Hospital, echoed these concerns and expressed the need to address health care worker shortages as a societal issue that affects everyone’s quality of life. She urged the use of resources to showcase health care occupations as attractive career choices. Bowman also suggested that the quality of life in the workplace needs to be improved so that people are attracted to the industry. 
 

Session 2: Strengthening Medicare
A wide range of health care voices joined in a panel discussion on ways to strengthen Medicare. Sharon Cohen, Vice President of Health Policy for the Biotechnology Industry Organization talked about the financial challenges related to research and development efforts. Cohen recommended Medicare solvency and greater reliance on the private sectors as ways to strengthen the system. 

Promoting local, community-based programs, Terri Gendel of HealthCare Choices, a program of the Suburban Area Agency on Aging, encouraged funding for outreach efforts and variety in the vehicles used to reach people (e.g, the Internet). Gendel also expressed her belief that such programs should be comprehensive and flexible because of the variety of stakeholders and diversity of beneficiaries. 

Speaking about the long-term viability of Medicare, Joseph Xanthopoulos, the Chief Organizational Development Officer and Vice President of Friendship Village, encouraged collaboration as the key to successful delivery systems. He also expressed his judgment that “one-stop shopping” will be the best option for the future while commenting that long-term care insurance is not the answer for Medicare.

Ann-Marie Lynch, Senior Advisor to the Secretary, U.S. Department of Health and Human Services, approached the question of how to strengthen Medicare by highlighting eight principles of Medicare modernization proposed by the Bush Administration:

1. Subsidized prescription drug benefits for all seniors, 
2. Better coverage for preventative care and serious illnesses, 
3. The option to stay in current programs without changes, 
4. Increased choice and flexibility,
5. Legislation that strengthens the long-term financial security of the program,
6. Better program management in order to provide superior coverage,
7. Streamlining regulations so that health care workers can spend more time with patients instead of paperwork; and
8. Rewarding health care organizations that provide high quality care to seniors. 

Keynote Address: Honorable Thomas A. Scully, CMS Administrator
Medicare and Medicaid - Big Changes, But A Big Ship to Turn (PPT) 

Thomas A. Scully, Administrator of the Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services delivered the keynote address entitled “Medicare and Medicaid: Big Changes – But A Big Ship to Turn.” The speech focused on the responsibilities and priorities of CMS, the largest purchaser of health care in the U.S. which is responsible for one in three dollars spent on health care -- approximately $1 billion per day. Scully highlighted CMS’s role in administering Medicare, Medicaid and the State Children’s Health Insurance Program (SCHIP), including its responsibility in insuring the health and safety of Medicare and Medicaid providers, the accuracy of clinical laboratory services and the regulation of individual and small group insurance. 

Scully also described CMS priorities such as providing “straight answers” to all Americans, facilitating open door outreach groups representing various health care constituencies, reforming the Medicare contractor system, working with states to ease out Medicaid DSH and UPL structures and developing better mechanisms to provide consumers information about their health care. Priorities for the program include working with Congress on Medicare reform and prescription drug benefits, working with states to improve Medicaid flexibility, pushing President Bush’s access proposal to cover more Americans, stabilizing the Medicare+Choice Program and improving SCHIP.