The topic of health care has been at the forefront of national and statewide debate. President and CEO of Virtua, one of New Jersey’s leading health care systems, Richard Miller told NJ Today Managing Editor Mike Schneider that the Affordable Care Act has been a “catalyst” for positive change in the delivery of health care. Miller said the goal will be on the wellness side of health care to try to prevent chronic illnesses and keep people in their homes and out of hospitals for treatments.
“The goal will be eventually to try to keep people out of the hospital and keep them in their homes for care. So things like chronic disease which are really prevalent in our society today, it’s going to be important that we care for people as much as we can outside the expensive walls of acute care hospitals,” Miller said. “And that’s going to be the goal we all have to have in this industry right now.”
Giving people access to health insurance is crucial, according to Miller. “Medicare rates are being cut for providers dramatically in this country,” he said. “To kind of offset that, we need more insured and the health insurance exchanges will provide availability to people to get that insurance.”
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Miller anticipates that it will take longer to get New Jerseyans insured than some might expect. He said the key is to strike a balance and transition from charity care paid by the state to Medicaid coverage and reimbursements. If charity care is cut right away, Miller said that would be problematic. Charity care reimbursements are currently inadequate when the cost of care is taken into consideration.
“It falls far short of what the actual charity care in the state is,” Miller said. “And don’t forget, charity care is reimbursed at Medicaid rates which is about 65 percent of cost. So you’re never covering your cost for Medicaid or charity care.”
Miller hopes with an increased number of insured residents, the reimbursement rate will be higher and more adequate in terms of coverage.
Mergers and acquisitions in the health care world have become increasingly common and Miller anticipates more in the future. “The reason for that is to get economy of scale and frankly to reduce cost and overhead in hospitals. So you’ll see hospitals coming together to create efficiencies,” he said. “We did a merger back in 1998 where two community hospitals came together to form Virtua and we did see significant cost savings, especially on the administrative overhead in health care.”
Many have pointed to an upcoming physician shortage and Miller agrees that primary care physicians will be scarce. “Primary care physicians do work a lot of hours to care for their patients and really aren’t paid very well by the payers for that work,” Miller said. He suggests offering incentives for caring for their patient population.
“That won’t change the fact that we’re going to see a primary care shortage and frankly while you’re seeing the advent of other practitioners like nurse practitioners and advanced practice nurses practicing and assisting primary care physicians in their offices,” Miller said.
Despite the challenges in the health care field, Miller said he’s optimistic about the future of health care. He said Virtua is going to focus on the wellness side of health care and illness prevention.
“My goal is to make sure that we give everybody an opportunity to have nutrition support, to have fitness and wellness and to limit chronic disease,” Miller said. “If we can do that well, I think we’re going to be successful.”