In a 5-4 decision the Supreme Court ruled in favor of healthcare reform marking a momentous occasion for Americans, hospitals, patients and all other parties in the healthcare continuum. However, now that reform has passed what will hospitals be doing differently that they previously hadn’t? There are several items that come to mind, but in general healthcare providers are still in a wait-and-see mode.
There is much in the air when it comes to how reform will impact hospitals. Some Republicans have vowed to repeal reform or at least limit its powers. Over half the states bet on reform not passing doing little to prepare for it and the Department of Health and Human Services (HHS) hasn’t completed making a clear list of rules for how states can put the law into effect. While there are some provisions that will be debated, there are some likely to move ahead.
3 Initiatives Hospitals Should Prepare For in the Future:
Change in Care:
Changes are being made for hospitals to provide more effective care while being held accountable for patient outcomes. It’s a change from the decades old fee-for-service meaning hospitals won’t make any more from Medicare or Medicaid by recommending more tests. Instead they’ll receive bonus payments for patient satisfaction, avoidable readmissions and a list of other measures to help promote quality care.
Accountable Care Organizations (ACOs):
ACOs will likely continue to be formed. Meant to support cooperation between independent care coordinators and hospitals, ACOs can play a large role in helping hospitals change and manage care. The goals of ACOs are to help incentivize the provider community to achieve better care for individuals, better health for populations and decreased per-person costs.
Insurance Company Partnerships:
No longer being able to discriminate against preexisting conditions and imposing lifetime limits on care received, health insurance companies will need to find ways of reducing costs while providing care to millions of more Americans. Blue Cross Blue Shield of Michigan is already taking action in this endeavor when it partnered with Trinity Heath-Michigan, and its 12 acute hospitals in a novel performance-based reimbursement payment plan.
The strategy ties higher reimbursement payments directly to Trinity Health’s success in providing better and higher quality care. By promoting integrated services and ensuring a smoother transition for patients across care settings, improved outcomes may be achieved for the health system’s population.
While there are numerous effects of healthcare reform from an influx of patients to ERs and primary care providers to insurance companies collaborating with hospitals to control care costs, the extent of those effects are still not fully known and we will continue to see how they play out.
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