Reform Ruling Provides Balance

I am relieved that the Supreme Court decision was not to strike down only the individual mandate. Whether one likes the ACA law or not, it was predicated on a balance.


I am relieved that the Supreme Court decision was not to strike down only the individual mandate. Whether one likes the ACA law or not, it was predicated on a balance. Both providers and insurers are subject to provisions that are difficult (payment cuts and requirements to cover more lives).

Those provisions are only possible to sustain if there is a strong incentive for all Americans to have health insurance. Although there wasn’t a lot of discussion about the impact on providers of health care, the scenario where we would have been subject to payment penalties and still have a large uninsured population to “cover for” would have been unsustainable.

 From an I.T. perspective, we were gearing up to be better able to bring information to bear in clinical and business decision making already. We are positioning to be able to provide the information needed to evaluate our participation in or sponsorship of an ACO, which is useful for many analytical and clinical needs other than an ACO.

We have been approved to convert one of our clinics to a Community Health Center to enable an expansion of services in a particular geographic region where a large percentage of the population doesn’t currently even seek care. We believe many of those patients will seek care when the provisions of the ACA are fully implemented. We are implementing the medical home concept and supporting those efforts with robust data and analysis.

Fortunately, we have built strong I.T. foundation and an EMR system that crosses the continuum of care. We are position to scale and adapt our system to the changes that are predicted as a result of the ACA.

That strategy continues to serve us well as we foresee continued volatility in the healthcare payments and politics. We hope, as everyone does, that we can move as a nation to a more sustainable, value-driven health care system.