A week after the U.S. Senate passed a health-care reform bill on Christmas Eve, health-care providers and consumers are trying to figure out what the proposed reform could mean for them.

Health-care providers agree reform is needed, but opinions vary on what form that reform should take. Some parts of the Senate bill are on the right track, they said, and some come up short.

In the coming weeks, bills passed by the U.S. House and Senate will be reconciled to come up with a final version. Rob Broermann, Sentara Healthcare's chief financial officer, predicted that the final version will closely resemble the Senate bill, passed by Democrats in a party-line vote.

"They can't lose a single Senate vote," he said. "The writing on the wall seems to be that if they don't come up with something very, very close to the Senate version, they can't pass it."

It's unclear how states will be able to pay their share, said John Littel, executive vice president of Amerigroup Corp., so he expects many changes to the final version.


The Senate bill will bring health insurance to millions of uninsured Americans, a huge victory for the uninsured, said Janice "Jay" Johnson, chairwoman of the Virginia Organizing Project, which aims to spur residents to take action on quality-of-life issues.

"Patients will be able to get good care, without being concerned that they're going to be turned away," said Johnson, a Newport News resident.

Many of those will be covered through Medicaid and CHIP, the Children's Health Insurance Program, but that won't happen until 2014, Littel said. Based in Virginia Beach, Amerigroup works with 11 states to administer Medicaid, CHIP and Medicare programs.

Johnson said she's disappointed the Senate version left out the government-run health insurance plan, or public option.

"It's a good starting place," she said of the Senate bill, "considering the fact that this country has been waiting so long for meaningful health-care legislation."


Reform might bring cuts to Medicaid and Medicare reimbursement to doctors and hospitals, which might reduce patients' access to providers, Broermann said.

"That, to me, is the biggest risk," he said.

That's also a concern of Dr. James Lesnick, a neurosurgeon and medical director of Riverside Medical Group. With millions of uninsured Americans now able to access health care, there could be a shortage of physicians, he said.

Riverside Medical Group originally formed to address a shortage of medical professionals by recruiting and retaining physicians, and the group is taking steps now to anticipate that demand, he said.

Also, part of the intention behind reform is to stop the rapidly escalating cost of medical care, so physicians and health systems must look for ways to provide better care more efficiently, Lesnick said.


The expansion of insurance coverage brings into question the role of free clinics, said Jim Shaw, co-founder of the Lackey Free Clinic in York County.