Leadership Group Offers Employers, Orgs Roadmap for Complying With Reform

The Patient Protection and Affordable Care Act has been maligned as a law that, despite its good intentions, will bloat government bureaucracy in a sluggish economy and set the stage for a federal takeover of the nation’s healthcare system.

Some pundits say that “trusted clinician” provider efforts to address operational inefficiencies that would eliminate $3.6 trillion in healthcare waste and avoid costs make up “a dismal history” and that accountable care organizations (ACOs) that try to do so are unlikely to accomplish their objective to create health through collaborative neighborhood health assurance initiatives.

 

No More Business As Usual

The nation of “disruptive improvement” is genuinely shaped by population health impact design methods and imaginative innovations that improve everyone’s economic well-being and quality of life.

Streetwise change agents realize that health and performance improvement continuous value enhancement is not just a law – it’s a robust movement to market-based transformation by fixing healthcare on the frontlines along the road to complying with this law. A recent cost-benefit analysis by the U.S. Social Security Advisory Board advised business leaders and consumers: “We do not underestimate the difficulty of what needs to be done. Nor do we underestimate the need to do it. The need is urgent. It is time to begin.”

If you are trying to avoid cost, you’ve got to become heavily involved in prevention. “Sick care” costs money. Prevention saves. It’s that simple. While Congress recently voted to repeal this landmark legislation, entrepreneurs, CEOs and their business-savvy workforces will continue to “bend the trend” on one valuable truth: “Necessity is the mother of all invention.”

The ACA could prove to be an inertia-busting catalyst for breathtaking change that brings together employers, employees, physicians, medical group practices and hospital systems. The upshot is that market forces would enable each of these key stakeholders to innovate and function as coherent organizations that facilitate real-time information exchange at the point of care, improve safety and operating efficiency, and provide advanced comparative effectiveness pathways and timely, world-class care to American citizens.

What’s more, the Congressional Budget Office predicts that if the ACA disruptive improvement were repealed it would ratchet up the federal deficit by about $230 billion over the next decade and leave 32 million more Americans uninsured.

It’s understandable that major work remains to be completed in defining and instituting the regulatory systems authorized by the ACA law. “The actuaries believe that regulatory systems will better anticipate future systemic risk by incorporating sound risk management principles. Any new regime should employ the appropriate oversight, expertise and accountability necessary to mitigate the effects of risks that could threaten the stability of the nation’s financial system,” says Andrew Simonelli, assistant director of communications for the American Academy of Actuaries.

“Despite the uncertainty and controversy it has generated, the ACA has sown the seeds for a major reorganization of the U.S. healthcare delivery system,” says Thomas L. Greaney, J.D., Chester A. Myers professor of law at Saint Louis University.

As a strategic imperative and serious economic strategy, the offshoots of the ACA include epidemic community health and performance improvement failures and wasteful behaviors in neighborhoods that drive operational inefficiencies in healthcare. The overarching objective for consumers to thrive is to achieve population health and performance improvement continuous value enhancement. Large financial considerations also are at risk.

“Repealing health reform would increase medical spending by $125 billion by the end of this decade and add nearly $2,000 annually to family insurance premiums; destroy 250,000 to 400,000 jobs annually over the next decade; and reduce the share of workers who start new businesses, move to new jobs, or otherwise invest in themselves and the economy,” says David Cutler, health economist, Harvard University, Department of Economics.

The ACA presents an opportunity to galvanize community leaders for a reinvention of healthcare through consumer-centered, neighborhood health assurance improvement initiatives that achieve healthy change. But the key to success will be changing the way they think. “There will be parties out there who wish to take advantage of the law, and the vocabulary to relabel what they already do and repackage the status quo,” said Dr. Donald Berwick, administrator of the Centers for Medicare & Medicaid Services, during a recent meeting at the Brookings Institution in Washington, D.C. “I don’t think that will be enough – not at scale. We are going to have to find a way to deliver care better, and that means change. And the question will be looking forward as we migrate into this terrain that seems to be, are you really in the game? Do you really want to provide better care at lower cost through improvement? Or are you simply taking what you already do and calling it something new, because that’s the game of today. That is the question I think we’ll be facing case by case and probably all together.”