Fiscal Cliff Set to Impact Local Healthcare

Iowa's hospitals and their 70,000 employees stand ready to care for their friends and neighbors 24 hours a day, seven days a week, 365 days a year. Day and night, holidays and weekends, they ensure that patients have access to the care they need at the right time, in the right place. But our hospitals' ability to maintain the kind of access to services that our communities have come to expect is threatened. In the wake of a critical national election, the debate over the national debt, the "fiscal cliff" and what to do about it has taken on particular urgency. It's sure to be the top issue as legislators return to Washington, D.C. And as those discussions move forward, the possibility of cutting Medicare and Medicaid funding for hospital services as a means to reduce the deficit will be on the table.

These proposals come during an already challenging time for your community hospital and health care providers. Among the most-pressing issues hospitals face:

• The high cost of the latest technology, equipment, devices and pharmaceuticals.
• The struggle to attract and train enough doctors, nurses and other caregivers to our state and in particular our rural areas.
• Meeting the needs of the growing number of seniors and other patients with multiple chronic illnesses.
• Underpayments from Medicare and Medicaid that shift the real costs of these programs to employers and other patients.
• Providing care for the uninsured and patients with inadequate health coverage. In 2011, Iowa hospitals provided nearly $600 million in charity care and dealt with more than $355 million in bad debt.
• Complying with increasing regulatory and payer requirements that sap hospital resources and keep nurses and physicians away from the bedside.

Even as George C. Grape Community Hospital grapples with these challenges, rest assured that we are working to keep health care affordable through innovations focused on improving the health of high-risk populations, such as people with diabetes or chronic heart conditions. Hospitals are increasing the quality and efficacy of care and better managing transitions, case by case, as patients are served in different parts of the hospital, in physician offices or at home.

And we're not alone in these endeavors. For example, hospitals across Iowa have formed the Iowa Healthcare Collaborative with physicians and other providers to better coordinate care, to work together to improve health care overall and to be accountable to the communities they serve. They are also carefully investing in technology such as electronic health records to improve care and efficiency.

Iowa's hospital leaders understand the fiscal challenges our nation faces. What additional cuts to Medicare and Medicaid funding for hospital services could mean to you:

• Longer wait times for emergency room care.
• Fewer doctors, nurses and other caregivers which squeezes access to care.
• Less patient access to the latest and most effective treatments and technologies.
• Fewer specialty services, particularly in rural areas, which compromises the delivery of community-based health care.
• Increased charity care and bad debt.
• Reduced financial capacity for continued hospital investments in community-based programs and services.

Economic Impact on the state:

At the same time, these cuts threaten Iowa's economy, where more than 136,000 jobs and nearly $6.2 billion are tied to hospitals. Our hospitals depend on Medicare and Medicaid for more than half of all their revenue, meaning cuts to these programs would impact every hospital and every part of the state and reverberate throughout the Iowa economy.
Iowa hospitals are united on this front and ask that the people of Iowa join them. The time is now for our elected officials to work together toward developing long-term fiscal solutions that will set Medicare and Medicaid on a path toward true sustainability for both their beneficiaries and the hospitals and providers who tirelessly serve their health care needs. Our patients and communities deserve to know that the care they need will always be there.