First Lady Michelle Obama introduced Let's Move, a nationwide campaign to tackle the challenge of childhood obesity

As health care reform progresses, wellness and prevention must be a priority.  It is, and has been, one of WakeMed’s top health reform priorities, particularly as the obesity epidemic is a very real issue in Wake County.  According to local research:

• 70% of adults living in Wake County are overweight/obese
• 52% of children 12-18 years of age are overweight/obese
• 24% of Wake county’s youngest children are overweight/obese

Locally, WakeMed has been working with children for years to curb obesity and prevent type 2 diabetes.  Dr. Piehl, director of WakeMed’s Children’s Hospital, created the Energize! program which is focused on altering lifestyles of children who are at risk of developing type 2 diabetes.  Our medical team is having great success in preventing the on-set of this disease with the program’s participants through a continued focus on exercise and healthy eating.  So much success, that the General Assembly appropriated funds a few years ago to North Carolina’s Division of Public Health to expand Energize! throughout the state.  Energize! has been implemented in nearly a dozen counties in North Carolina, from the coast to the mountains, and the Division of Public Health considers Energize! a “best practice” in the fight against type 2 diabetes.

Caring for individuals who suffer from type 2 diabetes, which stems from obesity, is a tremendous cost in our health care system. Preventative programs like Engergize! are a much more efficient way to save money and provide better care for patients – and these programs need to be the focus of future efforts to curb obesity in America.

In Wake County, Advocates for Health in Action (AHA), working in partnership Wake County Health & Human Services, recently applied for stimulus dollars through a proposal that outlines a $10 million comprehensive community initiative to put prevention strategies to work in Wake County. The proposed strategies will increase physical activity levels, improve nutrition and address obesity in our population. 

On the federal level, we are pleased that United States Senator Kay Hagan included a provision in the Senate’s final amendment to the health care reform bill to fight the diabetes epidemic in America.  The provision comes from Senator Hagan’s Senate Bill 1473 – The Catalyst to Better Diabetes Care Act of 2009.  More information can be found on her website.

We are also very excited that the fight against childhood obesity is gaining momentum in the white house. First Lady Michelle Obama has designated childhood obesity as one of her top priorities, and President Obama issued a memorandum yesterday announcing that his Administration will redouble efforts to solve the obesity epidemic within this generation.

One of WakeMed’s top priorities for health care reform is focused on preserving Medicare and Medicaid payments to hospitals.  Currently, individuals 65 years and older qualify for our county’s public insurance program, Medicare.  The federal government pays for Medicare services delivered by hospitals and health care providers.

The Medicaid program is run by states, and covers the poor and disabled.  The federal government contributes a two dollar match for every one dollar that the state pays to hospitals and providers under this program.  Most recently with the passage of the American Recovery and Reinvestment Act, Congress recognized that more and more individuals were flooding states’ Medicaid programs and that states could not keep up with these rising costs.  Congress temporarily increased its Medicaid match to help offset states’ budget deficits.

From the outside looking in, all of this looks and sounds good.  Government reimburses health care providers for the services they provide to the elderly, poor and disabled through these public insurance programs.  However, there is a caveat – government programs do not reimburse hospitals and providers the full costs of treating Medicare and Medicaid patients.  

I don’t know of any other business that does not get paid full costs for their products and services.  For example, let’s say you were to go to the grocery store to purchase an apple. Under the Medicare and Medicaid model, even though the apple cost one dollar you would really only pay 65 cents for it at the register. 

We always hear about the rising costs of health care services.  Health care providers lose millions of dollars caring for Medicare and Medicaid patients as well as millions for those who don’t have health insurance all together. 

I challenge our readers to devise a successful business plan for hospitals where the payments you receive for services delivered for over half of your customers fall short of covering your costs.  The trick is, the plan can not include increasing the cost of services to those who have private insurance plans. 

Expanding Medicare and Medicaid programs to cover even more individuals – as proposed in the House and Senate reform bills – will put an increased financial burden on hospitals and states.  Last year, the unreimbursed cost for WakeMed to treat Medicare and Medicaid patients was nearly $63 million. Adding more people to these government programs will only stretch our nation’s safety net hospitals farther. We have asked our Congressional delegation to limit an expansion of these public programs and continue to provide states with additional matching funds to help offset these costs.

This post is the second in a series about WakeMed Health Care Reform priorities

This morning I joined a couple of my colleagues for a “snow day” planning breakfast.  Those are the best types of meetings!   I shared with them WakeMed’s health care reform priorities.  After much discussion, one of my colleagues said “now this is what reform really needs to be about.” 

One of WakeMed’s top health care reform priorities currently being discussed is funding for the nation’s trauma centers.  There are currently six level 1 trauma centers in North Carolina, one of which is on WakeMed Raleigh Campus.  WakeMed serves as the Capital City’s trauma center.  Providing this high level of care does not come without a cost.  Level 1 trauma designation demands a tremendous financial commitment to staff a hospital with the level of specialists needed 24 hours a day, 365 days a year.  Additionally, as more and more individuals lack adequate insurance coverage, trauma centers often provide the most intensive, expensive clinical care to patients who are unable to pay for the care provided.

Language currently exists in both the House and Senate bills that would provide essential financial support to our nation’s trauma centers.  And both pieces of legislation offer funding opportunities to support the core mission of trauma centers.  The Senate bill also offers additional funding to help cover uncompensated costs associated with treating high volumes of patients who are covered by Medicaid or do not have insurance.

Additionally, the House bill provides “emergency relief” in the form of financial assistance to trauma centers during natural disasters and/or terrorist attacks.  Trauma centers are “first-receivers” during emergency events.  

WakeMed is discussing these important issues with our Congressional delegation, some of whom have had the opportunity to tour WakeMed and meet our trauma patients.  They saw firsthand how a community resource, like a trauma center, can make a tremendous difference in patients’ lives.

This post is the first in a series about WakeMed Health Care Reform priorities