MedPAC Meeting Update
Overall
For NAFEC leadership to get the best insight into the meeting, we would like to visit with you in person or on the telephone.
On 24 May 2016, for approximately forty-five minutes, Travis Lucas and Mike Chapman met with the senior-most staff of MedPAC. Among other things, the purpose of this meeting was to:
(1) let MedPAC know that NAFEC has competent representation in Washington, DC;
(2) open up transparent lines of communications with MedPAC; and
(3) explore ways to closely work with one another within the policy development process.
Overall, MedPAC staff have a genuine and curious interest in the FEC model. We didn’t notice any kind of negativity towards FECs. MedPAC staff mentioned that they had no immediate plans to make recommendations to Congress regarding FECs, but that they probably would make formal recommendations in late 2017. (They specifically mentioned a time frame of 12-18 months.)
Specifics
MedPAC staff were very interested in seeing if NAFEC could provide any kind of data, whatsoever (macro data or even granular data), on the FEC model that would allow them to compare and contrast FECs from other healthcare delivery models. We did not commit to delivering data.
Some examples of data they would like to analyze are:
• how our claims process works;
• what our cost basis might look like;
• how we remain or not remain financially viable in rural and inner urban settings;
• what is our patient mix, typical diagnoses and top ten diagnoses; and
• how we are fundamentally different than urgent care centers. (They mentioned that they only know the differences via anecdotal data and not any kid of empirical data.)
Continuing on the data attainment theme, MedPAC staff mentioned that when they were trying to learn about the specialty hospital model, there was a dearth of data (all of it anecdotal) so they worked with several specialty hospitals to create a survey of questions posed back to specialty hospitals. The data yielded from the survey was very helpful, and allowed MedPAC to get a good grasp on that industry.
MedPAC staff would also like to analyze the differences among the following models (especially focusing on the patient mix and, even to the extent we would share, audited financial statement showing profit and loss) regarding:
• the non-hospital affiliated FEC model (specifically in an affluent Houston suburban area) versus the “Adeptus-type Colorado hospital” model; and
• the rural non-hospital affiliated FEC model versus the rural hospital affiliated FEC model;
It is clear that they are very interested in the rural healthcare crisis overall, and in particular, how FECs fit into that ecosystem (i.e. can FECs be a possible solution). We discussed this subject in-depth.
MedPAC is interested in how efficient FECs are compared to traditional hospital run EDs.
MedPAC staff mentioned that they have actually toured an FEC that is affiliated with a Virginia hospital. We did not go into an in-depth conversation on this one.