Health care Q&A: Greg Pemberton

Greg Pemberton, a health care attorney at the local law firm Ice Miller LLP specializing in sales and
mergers among health care providers, discussed the biggest changes he expects to
come out of the federal health reform bills. On Thursday at the downtown Westin
hotel, Pemberton and his Ice Miller colleagues will describe how “it’s not going to be business
as usual” to about 100 local business leaders at a conference co-sponsored by the Indiana Chamber
of Commerce.

IBJ: Assuming something close to the Senate-House health
reform bills pass, what will be the biggest change in the law for health care providers?

A: The
disruption of so many changes all at once. There are so many changes being mandated in this legislation, it
really will by necessity have an impact on the way care is delivered. Probably the single biggest thing the provider community
is going to have to do is get ahead of these demonstration projects [such as Medicare paying multiple providers all at once
for one episode of care, or refusing to pay for patients readmitted to a hospital shortly after a stay there]. Some of these
this time are definitely going to have to be taken seriously because they represent the cutting edge of what the system is
moving to next.
 
IBJ: Even after passage, how much of the real impact of these bills
would remain “to be determined” by the administrative rule-writing process?

A:
There are some areas where rule making is going to be needed to flesh out the details of federal regulation.
But in some respects, there is going to be a much larger effect. That will be from benefit design and
assistance changes [by private employers]. That’s a very, very volatile market right now. You’ve
got to look at what your business model has been, because it’s going to change. It isn’t
going to be business as usual.
 
IBJ: Five years after these bills take effect [in
either 2013 or 2014] what’s the biggest change you expect to see in the Indiana/Indianapolis health care
landscape?

A: The safest thing to predict is a consolidation on the provider
side, from a business perspective and an operation perspective. With emphasis on hospitals, doctors,
home health, long-term care, the entire continuum. During [the] next few years, in the phase-in [of the
bills], that’s exactly what providers will do.