With the Supreme Court validating the individual mandate in health reform and tweaking Medicaid expansion provisions, hospitals will start to see a large decrease in uncompensated care, says Dave Roberts, vice president of government relations at the Healthcare Information and Management Systems Society.

Consequently, hospitals will financially be able to invest more in health I.T. beyond electronic health records to improve care coordination and quality, he adds. Health information exchange technology, accountable care organizations and a new HIPAA transaction for electronic funds transfers, among other reform initiatives, can really start to roll out now. And uninsured patients, brought into the system via the mandate, will increase their focus on health wellness and require supporting I.T. tools.

But there is a huge unmet challenge to reform and all the I.T. that will support it, Roberts cautions. Industry stakeholders are working together to come up with a nationwide way to identify patients. “If a nationwide solution isn’t proposed, it will be difficult to implement nationwide exchange of data.”

The political fight on reform is not over with the Supreme Court ruling, Roberts believes. One-third of Senate seats--with 10 of them open seats--are up for grabs in November, along with all 435 House seats (38 open). And both presidential candidates now have successfully implemented major health reform on a national or state basis.

Gov. Mitt Romney continues to pledge that he will act to repeal Obamacare if elected president. And House Republicans, if they retain control, will introduce legislation to repeal the law. But that’s as far as the legislation will go, Roberts predicts.

Business leaders, Republicans and Democrats alike, know that health care is a major drag on the economy and its costs need to come under control, Roberts notes. And many provisions of the reform bill are popular, such as parental coverage of adult children, coverage for pre-existing conditions and closing the Medicare prescription “donut hole.” Even the individual mandate is popular in polling if the mandate is explained and respondents understand it won’t raise their current insurance costs. So, it will be hard for Republicans to make many changes, he says.

 

 

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