Over the last few pandemic years, the general public and healthcare leaders have realized the importance of Federal and State policy. I write to you with 15 years of healthcare experience, including clinical roles, operational leadership, organizational strategy, and public policy. As a former healthcare administrator working in policy for the last three years, I have a newfound perspective on the impact of policy on daily healthcare operations, the future outlook on the healthcare industry, and, most importantly, patient care. After developing and leading the policy division for my current company, Invitae, I’ve been horrified when I think about how much I was uninformed and disengaged in policy as a healthcare administrator. Federal and State guidelines have significant benefits and consequences on the work of healthcare administrators. Let’s look at some examples.
Telehealth and other digital health tools have tremendous innovation and advancement during the pandemic. The adoption has been at record speed and unimaginable for most healthcare administrators in the pre-pandemic world. Thanks to the Federal government, telehealth reimbursement and flexibilities continue to be extended during the public health emergency. Many efforts are made to make telehealth reimbursement and access permanent beyond the declared emergency. This all sounds wonderful, but what if I told you there were efforts that I helped stop that were aimed at requiring in-person visits within a specific time period (6 months or 12 months) of a telehealth visit for Medicare patients and were dependent on the type of laboratory test being ordered during a telehealth visit? That would have been a disaster for healthcare administrators to implement workflows and comply with the restrictions.
Another example is the overturning of Roe v. Wade. Fortunately, we are lucky to live and work in a state with goals of expanding reproductive rights and access to services, unlike many other states that are starting to restrict access to care severely. But did you know that a bill is being considered to provide abortion services to out-of-state individuals seeking help in California? Despite your political stance or viewpoint on the policy, as healthcare administrators, we should be preparing for this influx of patients seeking reproductive health services. Do you have enough providers? Nurses? Social workers? Grief counselors? Exam and procedure rooms? How will these services be billed or reimbursed? All of this will fall on your shoulders to navigate. Again, despite your personal or political views, we should be engaged in this policy and its implementation.
On the bright side, what if I told you there was a California bill (SB 1191) working its way through the legislature for enactment into law that would help you better manage patient medications, reduce hospitalizations and ED visits for MediCal patients, reduce total costs per patient, and improve patient outcomes? A coverage mandate bill that would require Medi-Cal to cover a healthcare service (i.e., pharmacogenomics) would ultimately benefit essential performance metrics for you and your organization. You would probably be interested and want to know how to help and provide this type of newly covered service. For example, does your healthcare organization already offer the service, do you need to explore contracting, and what about patient/ provider education? We shouldn’t constantly be reacting to policy. The real question is—how can healthcare administrators be helpful in policy and prepare for enacting laws that impact daily operations? It can seem scary, risky, and out of our wheelhouse sometimes.
Dare I say– if healthcare leaders were more engaged in policy, I believe the pandemic’s navigation would have gone more smoothly, and perhaps the burnout would have been reduced. We are the best and most important stakeholders to engage in health policy. YOU are strategizing, directing, and managing the healthcare of patient populations in California. Shouldn’t YOU have a say and provide YOUR expertise in proposed legislation that impacts YOU, your organization, and your patients? I think so!
CAHL has a unique opportunity and ability to provide a united voice for healthcare leaders to improve California’s health policy. It is time to no longer stand on the sidelines and react to policies. It is time to engage, provide our voice, and proactively shape policies that are best for healthcare delivery, patients, and population health. The time is now for CAHL members to consider policy engagement. I am here and ready to lead a CAHL Advocacy committee in close collaboration with California Hospital Association, but nothing is ever accomplished alone. Healthcare takes a village, a community, and diverse thought. So, I pose the question to you: Are you game for CAHL Advocacy?
Join me and other healthcare leaders on July 14th at 5:30PM to discuss and share your opinions on Federal or State policies that impact California health policy.
Register at https://buff.ly/3acpb0A
Vice President, Healthcare Transformation + Head of Public Policy