Fine said she anticipates a legislative fight over CON, which is a law passed in 1979 to contain overbuilding of hospitals and health care institutions. Emory opposes the total repeal and has been working during the past year with the Alliance for Community Hospitals to develop a compromise proposal. In support of that compromise, Michael M. E. Johns, executive vice president of health affairs, submitted extensive testimony to the Hospital Restructuring Committee on Jan. 22. Specialized services also will be threatened because it's not profitable to provide them. But our biggest argument is that quality of care and outcomes will suffer if there is a diffusion of excellence among small health care centers.
Many studies show that good outcomes rely on a concentration of highly skilled teams.
But in light of the political realities, which include a good deal of sentiment to do away with CON, Emory has worked with the Alliance for Community Hospitals on an alternate proposal. Beyond CON, Fine is concerned with budget issues that include Hope Scholarships, Medical Education, Emory-held state contacts, the Georgia Research Alliance and Medicaid. Fine has developed a legislative position for each of these funding issues. In the past the expenses of medical education have been subsidized by patient care revenues, but managed care is driving away this subsidy and funding within Medicaid and Medicare is in jeopardy. No institution could pay the true costs of medical education, so we're looking to propose new ways to fund it, perhaps the creation of a trust fund within Medicaid or other mechanisms.