December 11, 2012
Contact: John Clayton
Vice President for Communications

By Steve Ahnen
Special to The Monitor

CONCORD - There has been a lot of discussion lately about the potential impact of the so-called "fiscal cliff" and budget sequestration on our economy nationally as well as here in New Hampshire. The stakes are highest for the defense industry, for social programs like Medicare and Medicaid and for our ability to increase economic activity and create new jobs. Remedies to the fiscal cliff are being discussed at the highest levels in Washington today, but may include solutions that could have a significant and disproportionate impact on Medicare and Medicaid here in New Hampshire as compared to other parts of the country.

Solving these challenges is going to require shared sacrifice on the part of all sectors of our economy, including health care. And while hospitals are preparing for the kinds of reforms and changes that will be necessary, what we do not need is the same reactionary response that we've seen over and over again that will impede economic growth and ultimately harm patients and our ability to care for them.

A report issued in September by Pittsburgh consulting firm Tripp Umbach for the American Hospital Association, the American Medical Association and the American Nurses Association noted that within the first year of funding cuts as a result of sequestration, more than 496,000 healthcare jobs would be lost nationwide, including more than 2,300 jobs here in New Hampshire.

Some of the changes under consideration would have a disproportionate impact on New Hampshire's Medicare and Medicaid beneficiaries and our health care providers. One such provision would change how hospitals are reimbursed for certain services provided in hospital outpatient departments. Under that approach, New Hampshire would suffer the second largest cut under Medicare for outpatient evaluation and management services of any state in the country. Another option being considered could dramatically change how the thirteen rural, Critical Access Hospitals in New Hampshire are funded.

As it stands today, if no change in law is made, physicians will see their Medicare reimbursements cut by almost 30 percent beginning January 1, which could negatively impact the care that Medicare beneficiaries here in New Hampshire are able to receive. That must not be allowed to go into effect, nor should it be solved by cutting payments to other providers, including hospitals.

Nevertheless, as legislators in Washington grapple with these challenges, they are considering reductions to those very payments to help pay for the cost of fixing the physician payment issue, as well as other health care provisions that are part of the "fiscal cliff."

Hospital leaders are already facing difficult challenges to ensure that patients continue to have timely access to essential services, and additional cuts to Medicare and Medicaid funding for hospital services would mean longer wait times for care; fewer doctors, nurses and other caregivers; and less patient access to the latest treatments and technology.

This is not just the position of one healthcare executive.

A national survey of registered voters conducted last month on behalf of the American Hospital Association found that nearly seven out of 10 voters reject cutting hospital funding for Medicare and Medicaid. The poll also showed that voters believe if funding were reduced, it would decrease access to health services for seniors.

That survey, conducted by the respected polling firm of Public Opinion Strategies, concluded that "This complete rejection of such a reduction in reimbursement to hospitals is at least in part grounded in the strong positive regard voters hold for hospitals."

We cherish the fact that our hospitals are held in such high regard, and we look forward to continuing to work with our Senators and Representatives in Washington to protect New Hampshire's patients and the health care providers who care for them and ensure that the Granite State is not disproportionately affected as these critical challenges are addressed.

(Steve Ahnen is the President of the New Hampshire Hospital Association)