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Affordable Care Act, rural hospitals the topic of panel discussion Wednesday

Reporter Jaclyn Cosgrove live tweeted from the "Preparing for Health Care Reform after the Supreme Court Decision" health panel in Oklahoma City Wednesday. Read highlights from the discussion below.

By Jaclyn Cosgrove | Published: September 26, 2012 Comment on this article

Reporter Jaclyn Cosgrove live tweeted from the "Preparing for Health Care Reform after the Supreme Court Decision" health panel in Oklahoma City Wednesday. Read highlights from the discussion below.

@jaclyncosgrove 11:40 a.m. Just arrived at the OU College of Public Health (801 NE 13th St.) for a noon panel on health care reform. I am live tweeting the event.

@jaclyncosgrove 12:00 p.m. A good mix of folks attending this health care reform panel. I noticed some folks from the Oklahoma Health Care Authority are here.

@jaclyncosgrove 12:07 p.m. Dr. Robert Roswell, senior assoc. dean at the OU College of Medicine, starts the discussion, talking about the ACA implications in Oklahoma.

@jaclyncosgrove 12:10 p.m. Roswell: 2010 marks one of the first times in about 40 years that the U.S. has seen substantive health care reform #aca #healthcare

@jaclyncosgrove 12:15 p.m. Roswell explains that SCOTUS said individual mandate is unlawful under the Commerce Clause, but lawful as a tax imposed by Congress.

@jaclyncosgrove 12:19 p.m. Roswell uses letter from CMS director to explain Medicaid expansion -- talkbusiness.net/wp-content/upl… -- An interesting read.

@jaclyncosgrove 12:22 p.m. Roswell discusses medical loss ratio -- cciio.cms.gov/programs/marke… -- and the difference between small and large group plans.

@jaclyncosgrove 12:24 p.m. A term to learn when trying to understand health care reform -- Disproportionate share hospitals -- hhs.gov/recovery/cms/d…

@jaclyncosgrove 12:26 p.m. Roswell: Medicare/Medicaid cuts to hospital total $155 billion over 10 years, including $40B reduction in disproportionate share hospitals.

@jaclyncosgrove 12:30 p.m. Roswell: The way the exchange works is – the patient goes to the exchange, finds plan through a premium, tax credit, cost sharing, Medicaid

@jaclyncosgrove 12:31 p.m. ** That tweet sent too soon. To clarify, if a person decides to use the exchange, some of it relates back to where s/he is on poverty line.

@jaclyncosgrove 12:32 p.m. Roswell: Oklahoma received the largest grant of an state in U.S. to develop a health insurance exchange, returned it to federal government.

@jaclyncosgrove 12:34 p.m. And now Val Schott, Oklahoma Health Information Exchange Trust CEO, will discuss rural health care and #ACA.

@jaclyncosgrove 12:37 p.m. Schott: 45.4% of Oklahomans live in urban areas, 45.7% live in rural area. Only 33% of primary care providers practice in rural Oklahoma.

@jaclyncosgrove 12:39 p.m. Schott: In terms of our numbers per capita on primary care providers, Oklahoma is "the worst of the worst" in U.S.

@jaclyncosgrove 12:41 p.m. Schott: Oklahoma has so many rural hospitals because it has no transportation system. Access to transportation is critical.

@jaclyncosgrove 12:45 p.m. Schott: Average income in rural Okla: $36,324; Urban: $45,233. Lack of income, education and insurance contribute to poor health outcomes.

@jaclyncosgrove 12:46 p.m. Schott: Oklahoma’s uninsured population costs Oklahomans $954 million annually in cost shifting. There are 661,000 Oklahomans uninsured.

@jaclyncosgrove 12:48 p.m. Gary Raskob, the OU College of Public Health dean, is now talking about what drives the cost of health care and also the ACA provisions.

@jaclyncosgrove 12:52 p.m. Raskob quotes research that says more than 60 percent of health care cost is driven by growing number of sick people in U.S. who need care.

@jaclyncosgrove 12:53 p.m. Raskob: About 30 percent of growth in health care cost between 1987 and 2002 is attributable to obesity/overweight.

@jaclyncosgrove 12:56 p.m. Raskob: Most efforts to control cost have focused on deductibles, co-pay, HSA; You must focus on improving the health of the people served.

@jaclyncosgrove 12:59 p.m. Another #ACA term to familiarize yourself with -- The Prevention and Public Health Fund -- healthaffairs.org/healthpolicybr…

@jaclyncosgrove 1:02 p.m. Raskob: The opponents of the #ACA are taking the approach of, if you cannot overturn the law, defund it.

@jaclyncosgrove 1:04 p.m. Raskob finished his comments, and now it's time for discussion. Dr. R. Murali Krishna is first with a question about the funding of #ACA.

@jaclyncosgrove 1:08 p.m. Q from audience: What can telemedicine and telehealth do to help with health care access issues in rural Oklahoma?

@jaclyncosgrove 1:08 p.m. Panelists answer: Telemedicine is great, but Oklahomans still need a primary care physician to go to. The state still needs more PCPs.

@jaclyncosgrove 1:11 p.m. Audience question: If Oklahoma opts of Medicaid expansion, could that result in rural hospital closures?

@jaclyncosgrove 1:12 p.m. Panelists answer: Rural hospitals face many obstacles as health care grows more complicated. For example, many struggle to make payroll.

@jaclyncosgrove 1:13 p.m. Audience member asks -- is the #ACA a good thing or a bad thing?

@jaclyncosgrove 1:14 p.m. Panelist: U.S. has highest per capita health care expenditure but quality of care is highly questionable. Anything to increase access helps.

@jaclyncosgrove 1:17 p.m. Panelists also say #ACA is "big step forward," but we must get American population healthier to consume fewer health care resources.

@jaclyncosgrove 1:20 p.m. The panel is over. I'll have a story up as soon as I can. Lots of interesting stuff covered today, especially in the realm of rural health.