1. HEALTH CARE REFORM: Washington Update Reengineering Steering Committee South Carolina Hospital Association February 11, 2011 James Bentley, Ph.D. Silver Spring, Maryland

2. Legal Status Federal District Court Decisions –Western District of Virginia: Liberty University v. Timothy Geithner –Eastern District of Michigan: Thomas Moore Law Center v. Barack Hussein Obama –Eastern District of Virginia: Commonwealth of Virginia v. Kathleen Sebelium –Northern District of Florida: Florida v. Sebelius Pending Litigation –About 22 more cases in a variety of courts Likely final forum: US Supreme Court

3. Administration Continues to promulgate regulations Continues to disburse funds Explores alternatives to individual mandate –Limited open season –Higher premiums for delayed enrollment –Mandatory lockout –Allow pre-existing condition exclusion

4. Congress House passed repeal –Asked committees for replacement options Senate rejected repeal Republican strategy –Incremental ways to limit the law –Two must-past pieces of legislation Early March: Current year Federal budget April: Increase in debt ceiling

5. Reengineering Stimuli Base periods underway now or soon –Penalize high readmission rates Competing against yourself Base = 2010-2012 –Value-Based Purchasing in Medicare Base = 2010-2012 –Penalize hospital-acquired conditions Competing against all hospitals: Base = 2012-2014