Earlier this month, the U.S. Supreme Court heard testimony for and against the continued existence of the two-year-old health care reform law that was passed by the Obama administration. Currently, the Court is in closed-door deliberations, with a decision expected in June, while pundits from all political persuasions trade speculations about what the verdict will be, and what might happen in either scenario (some say that a ruling that the law is unconstitutional will actually be WORSE for the Republican party).
Meanwhile, insurance industry leaders believe that no matter what the courts say about the Patient Protection and Affordable Care Act, at least some parts of the legislation will remain in force, if for no other reason than the passage of the act in the first place has pushed the insurance industry into a period of change.
According to Ronald Swinford, president and CEO of the Lehigh (PA) Valley Health Network, that’s because there are some benefits of health care reform that even people like him want to keep.
Swinford is not alone in his opinion, either. Stuart H. Fine, CEO of Grand View Hospital believes that even if the biggest point of contention, the mandate that everyone must purchase some kind of coverage, is struck down, there are other sections of the reform law that will either remain in effect or be reinstated by future congressional voting no matter what the ruling.
Both men were interviewed recently by the Lehigh Valley Morning Call, to talk about health care reform, and the legality thereof, and both pointed out that until there is a ruling, the Act remains in force, and industry leaders are behooved to work toward compliance.
Among some of the reform requirements being implemented, which Fine referred to as a “grand, complicated and in many ways undefined experiment,” are payment reforms for Medicare and Medicaid, the creation of insurance exchanges where consumers without access to corporate benefits can purchase coverage, and the tactic of larger companies absorbing private practices in order to provide better coordination of care (they say) as well as the development of secure electronic medical records systems.
Swinford, specifically, told the Morning Call that he believes evolution away from the existing fee-for-service health care model and toward one that puts a premium on quality care and ensures that providers are paid for actual value is likely to continue. Also weighing in was Sally Gammon, president and CEO of the Good Shepherd Rehabilitation Network said she things the law has forced more cooperation and resulted in more integration of care levels, away from separately-licensed inpatient rehab facilities and long-term acute care providers to a continuing care program, which will result in a streamlines system that ultimately provides better care with fewer errors and gaps.
If this sounds like a sunny picture of the change wrought by health care reform legislation, consider that there are also some aspects of it that health care execs do not like. Swinford observed that very few hospitals are truly on-board with the use of accountable care organizations (a payment/delivery system that the law pushes for), while almost all industry leaders feel that things are far too nebulous and complex. Overall, the people who do the day-to-day administration of health care feel that reforms should simplify processes, rather than make insurance law even murkier, but, Swinford added, the worst outcome would be a law weakened so much it would do nothing.